Authors

  1. Catalano, Kathleen RN, JD, FHIMSS

Abstract

Pay-for-Performance programs reward physicians, hospitals, and other providers of healthcare when the services they provide reach predetermined quality and efficiency goals. On the other hand, the Recovery Audit Contractor program is a form of Pay-for-Performance through which private companies hired by the Centers for Medicare & Medicaid Services identify improper payments made on claims of healthcare services to Medicare beneficiaries. Pay-for-Performance programs and the Recovery Audit Contractor project are discussed in this article in an effort to provide a baseline of understanding about these programs to those working in peri-operative areas.