Q: What are some examples of how an organization can ensure that when the organization provides financial incentives to its staff, the organization has a process to ensure that the integrity of clinical decision making is not compromised?
A: Nursing agency - A nursing agency compensates its nurses $10.00 extra for each visit over 6 visits per day. The agency implements a mechanism based on 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.
Home Medical Equipment Company - A home medical equipment company which receives a flat capitated rate for a wheelchair has a policy for sharing 10% of any profit with its Customer Service Representatives. 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.