Hospital Outpatient Prospective Payment System (HOPPS) is a payment system that was established in August 2000 by government legislation to create prospectively set payment rates for designated hospital outpatient services. It is administered by the Centers for Medicare and Medicaid (CMS). The following services are covered under HOPPS¹:

“Pay-for-performance (P4P) is an umbrella term for initiatives aimed at improving the quality, efficiency, and overall value of health care.”¹ It is a term involving payment models that tie reimbursement to metric-driven outcomes, practice guidelines, and patient satisfaction in order to improve the overall quality and value of health care. There are numerous quality metrics that can be utilized, with the majority spanning across 4 domains: patient/caregiver experience, care coordination/patient safety, preventive health, and at-risk populations. The metrics used are publically reported, creating transparency and further incentivizing organizations to protect and strengthen their reputations. Both the Centers for Medicare and Medicaid Services (CMS) and commercial payers have created P4P models in order to play a role in the national strategy to transition health care to value-based medicine.

Telehealth is defined as the exchange of medical information through electronic communication to improve a patient’s health.¹ Although often used interchangeably with “telemedicine,” telehealth encompasses a broader array of services and activities. Telemedicine solely describes the use of telecommunication to provide health care directly to a patient, while telehealth includes talking to a doctor live via phone or video chat, sending/receiving secure messages between providers, and remote monitoring of medical devices. Telehealth is one element of digital health, which is a broader term that includes “disruptive technologies that provide digital and objective data accessible to both caregivers and patients.”² Examples of technologies that provide digital data include wearable devices and mobile health technologies.