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Recent health policy developments have stimulated renewed interest in the use of performance-based payment as a tool to improve health care quality and cost control. In 2014, the Medicare Shared Savings Program (MSSP) was launched, providing more than US $20 billion in financial incentives for hospitals to improve their performance on quality measures. While the program is voluntary, Medicare and many other payers consider it a proven way of incentivizing efficient, quality care. This study analyzes changes in providers’ behavior and their attribution of change to the MSSP among nearly 1,000 hospitals and more than 17,000 providers for hospitals that participated in the MSSP during its first three years. We find a spillover effect on providers’ quality-based payments by up to 7.9%. Provider-specific characteristics at baseline that explain poorer performance in the baseline period are, on average, also associated with lower quality-based payments in the second and third periods. These results contribute to the understanding of the dynamics of the new payment program.Q:
Partial ordering in Hanoi Towers
While playing Hanoi Towers with my partner, we have a realization that the game can be partially ordered using the following relation:
A cell, R(a,b,c) > B(a,b,c) if the tower that has a stack containing the disks a, b, and c is lower than the tower that has a stack that contains the disks a, b, and c.
I’m interested in what happens if we sort this ordering by:
Number of disks remaining to be stacked, if a tower has 3 disks remaining to be stacked, then it is greater than a tower with 7 disks remaining to be stacked.
The final disk in each tower.
My suspicions are that the first condition is provably a strict partial ordering, but I’ve never seen a proof of that. Similarly, for the second, I could imagine that the final disk in the tower is equal to
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