Successful incorporation of performance based payments for trauma center readiness costs into the Georgia trauma system

Dennis W. Ashley, Jeffrey M. Nicholas, Christopher J. Dente, Tracy J. Johns, Laura E. Garlow, Gina Solomon, Dena Abston, Colville H. Ferdinand, Amina Bhatia, Karen Hill, Peter Rhee, Elizabeth Atkins, Tracy Johns, James Dunne, Rochelle Armola, Colville Ferdinand, Regina Medeiros, Amy Wyrzkowski, Jim Sargent, John CasconeDaphne Stitely, John Bleacher, Tracie Walton, Clarence McKemie, Melissa Parris, Romeo Massoud, Jeffrey Nicholas, Steven Paynter, Kim Brown, Scott Hannay, Leslie Baggett, Nathan Creel, Jesse Gibson, Thomas Hawk, Heather Morgan, Barry Renz, Laura Garlow, Mark Gravlee, Aruna Mardhekar, Angelina Postoev, Melanie Cox, Kelly Mayfield, Jaina Carnes, Robert Campbell, Alxe Jones, Robert Scheirer, Misty Mercer, Michael Thompson, Joni Napier, John Sy, Dana Shores, Brad Headley, Gail Thornton, Michael Williams, Karrie Page, Dennis Spencer, Michelle Benton, Garland Martin, Michelle Murphy, Walter Ingram, Kelli Scott, Fred Mullins, Farrah Parker, M. Joseph, J. Patrick O'Neal, Renee Morgan

Research output: Contribution to journalArticlepeer-review


As quality and outcomes have moved to the fore front of medicine in this era of healthcare reform, a state trauma system Performance Based Payments (PBP) program has been incorporated into trauma center readiness funding. The purpose of this study was to evaluate the impact of a PBP on trauma center revenue. From 2010 to 2016, a percentage of readiness costs funding to trauma centers was placed in a PBP and withheld until the PBP criteria were completed. To introduce the concept, only three performance criteria and 10 per cent of readiness costs funding were tied to PBP in 2010. The PBP has evolved over the last several years to now include specific criteria by level of designation with an increase to 50 per cent of readiness costs funding being tied to PBP criteria. Final PBP distribution to trauma centers was based on the number of performance criteria completed. During 2016, the PBP criteria for Level I and II trauma centers included participation in official state meetings/conference calls, required attendance to American College of Surgeons state chapter meetings, Trauma Quality Improvement Program, registry reports, and surgeon participation in Peer Review Committee and trauma alert response times. Over the seven-year study period, $36,261,469 was available for readiness funds with $11,534,512 eligible for the PBP. Only $636,383 (6%) was withheld from trauma centers. A performance-based program was successfully incorporated into trauma center readiness funding, supporting state performance measures without adversely affecting the trauma center revenue. Future PBP criteria may be aligned to designation standards and clinical quality performance metrics.

Original languageEnglish (US)
Pages (from-to)966-971
Number of pages6
JournalAmerican Surgeon
Issue number9
StatePublished - Sep 2017

ASJC Scopus subject areas

  • Surgery


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