Q: What are some examples of how an organization can ensure that when it provides financial incentives to its staff, it has a process to ensure that the integrity of clinical decision making is not compromised?
A: A nursing agency may compensates its nurses $10.00 extra for each visit over 6 visits per day. The agency evaluates the patient outcomes or satisfaction data to ensure that the nurse is not performing unnecessary visits just to make the extra money, or the nurse is not cutting visits short to allow time for additional visits to make extra money.
A home medical equipment company that receives a flat capitated rate for a wheelchair shares 10% of any profit with its Customer Service Representative. The organization has a mechanism to ensure that when the CSR recommends a cheaper wheelchair that would generate a larger profit, the wheelchair meets the patient's needs and specifications. If it does not meet the patient's need, an appropriate wheelchair which may be more expensive is provided.