Summarize the article Essay Example | Topics and Well Written Essays - 250 words - 2

Summarize the article - Essay Example government-mandated labels are â€Å"the energy star ratings used on household goods and environmental hazard warnings required on pesticides and products with CFCs or toxic substances† (DSouza, 2004). Self-declarations are the claims of manufacturers such as â€Å"recyclable† or â€Å"biodegradable†. These environmental labels affect different types of green consumers and their buying habits. D’Souza used a two-dimensional model to present the four types of green consumers namely, the environmentally-green consumers, emerging green consumers, price sensitive green consumers, and conventional consumers (2004). These consumers are differentiated on the basis of their cognitive and non-cognitive perspectives, and the perceived product benefits and risks. They behave differently towards label information. It is necessary therefore for marketers and manufacturers to segregate their target markets and determine the category to which they fall. The type of consu mer and their response to the label and ecological attributes of the product have marketing implications which must be considered in the design of the marketing strategies of companies. Environmental labelling should be a primary concern of every manufacturer today because of the growing concern for environmental issues. Label information will help selective consumers to make informed purchasing decisions, whether they are green consumers or

Crime and disorder act 1998

Crime and disorder act 1998 The ratio of the case is that within section 28(4) of the Crime and Disorder Act 1998 those who are not an immigrant of the country, in other words those who are not of a British origin, do represent a racial group. Section 28(4) of the Act defines the term racial group which includes nationality (including citizenship) and national origins along with race, colour and ethnic origin. The addition of nationality in the Race Relations Act 1976 section 1 subsection (1)(b)(ii) established that discrimination against the non-British was no longer allowed and therefore it didnt matter that the offender hadnt referred to the women as Spaniards, the fact that he mentioned foreigners indicate the non-British and demonstrates racially aggravated discrimination under the 1998 Act. The Court of Appeal addressed the central issue by focusing on the language of section 28 of the Crime and Disorder Act 1998, which includes the two circumstances under which an action would be considered to be racially aggravated, in subsection 1(a), the meanings of certain words in subsection 1(a), the basis of the offence and the meaning of the term racial group. The first key step in reaching the conclusion was mentioned by Baroness Hale, that the basic offence has been committed and that the offence is either racially or religiously aggravated under section 28 of the Crime and Disorder Act 1998. The next step towards the reasoning mainly concerns subsection 1(a) which states that before, after or at the time of committing the offence, the offender demonstrates conducts hostility towards the victim which is based on the victims membership or presumed membership of a particular racial or religious group. This subsection is based on an outward manifestation of hostility towards racial or religious groups and that is what the House of Lords (HL) interpreted for this case. The HL then accepted that if the offender had referred to the victims as bloody Spaniards instead of bloody foreigners which were the exact words the offended had used. However according to the 1998 Act the hostility must be shown towards a particular group instead of foreigne rs. Then it has been mentioned that the Act requires to be defined by what it is rather than what it is not. Thus the term Spaniards would be covered in the Act but not the term foreigners which refers to all non-British. Then it was established by the HL that the criterion by which the victims are defined, whether it is defined solely by reference to what the group members are not or broadly by reference to what they are, is the same. Finally the last step towards the final decision of the case was to obtain the answer to the question; whether or not non-British people, those who dont come from a British origin, represent a racial group within section 28(4) of the Crime and Disorder Act 1998, to which the answer given was affirmative as it would be had the question been regarding whether foreigners represented a racial group within section 28(4) of the Act. I find the House of Lords decision to be convincing because of the following reasons: The offender has committed an offence and has demonstrated hostility towards the three Spanish women. The evidence for this lies in the fact he then pursued them in a kebab shop in an aggressive manner. The word aggressive is important in this context as it proves that he has shown hostile behaviour towards the three women. According to the facts of the case, after having said bloody foreigners and go back to your own country he then pursued them in a kebab shop in an aggressive manner. This indicates that the offender has committed a racially aggravated crime under section 28 , subsection 1(a) of the Crime and Disorder Act 1998 which states that one of the circumstances under which an offence will be considered racially aggravated is if the offender demonstrated hostile behaviour towards the victims any time before, after or at the time of the offence, based on their racial backgrounds. Therefore the use of the word then satisfies this subsection of the 1998 Act because it indicates that he demonstrated hostile behaviour after committing the offence. It has already been proved that the act was racially aggravated and such acts lead to the denial of respect and dignity towards those who are considered as the others. They are never looked upon as part of the community and it is more hurtful to the victims as such conduct is likely to make them feel discriminated due to their racial backgrounds. Baroness Hale referred to the case of Director of Public Prosecutions v M [2004] 1 WLR 2758, where the Divisional Court held that the use of the terms bloody foreigners could portray hostile behaviour towards a racial group, depending on the context. The fact that Baroness Hale referred to this example to back up her opinion makes the final decision more convincing. Baroness Hale also mentioned that in Attorney Generals Reference (No 4 of 2004) [2005] 1 WLR 2810 the CA (Court of Appeal) held that someone who is an immigrant to this country and therefore non-British could be a member of a racial group for this purpose. This statement makes the decision really convincing because it actually states that the three Spanish women, being foreigners and therefore non-British, did constitute a separate racial group and hence the offenders appeal was dismissed. Baroness Hales opinion also includes examples which illustrate a clear distinction between words or phrases which demonstrate hostility towards a racial group and words that only demonstrate hostility towards foreigners only. One such example of this is Wogs begin at Calais which demonstrates hostility towards all foreigners and bloody wogs which is considered to have specific racial connotations. According to an article from telegraph.co.uk , the word wog is a vulgar name for a foreigner. So in other words the term bloody wogs which according to Baroness Hales opinion has racial associations, can also be translated to bloody foreigners. Therefore it shows how the expression bloody foreigners, used by the offender in the case, is a vulgar expression that insulted the three Spanish women. This further makes the House of Lords decision convincing.

Comparing Diversity in Crying of Lot 49, Good-bye, Columbus, and Survivor :: comparison Compare Contrast essays

Theme of Diversity in Crying of Lot 49, Good-bye, Columbus, and Survivor Diversity is an attribute that is seen among people, situations and cultures. Everyone has encountered different situations at one time or more during their lives that has either been pleasant or upsetting. Certain novels written in the 1950's to the present show signs of multiformity very clearly. In regards to culture, people are placed in unusual situations where their diversity is shown. Throughout the novella, "Good-bye, Columbus," written by Philip Roth, conflicts are seen as far as social status among families. This novella was not diverse in the written aspect, in fact I thought of it as easy reading. "Sure, I should serve four different meals at once.... I should jump up and down twenty different times? What am I, a workhorse?" (Roth 4) The reactions in Brenda's house differ because they have a maid and Brenda's Mom doesn't have to pick up a finger. Neal and Brenda's families are obviously placed in different social brackets and this adds to the conflict that the relationship is not equal. From the readers point of view, the tie that Neil feels toward Brenda is one of physical attraction. "She dove beautifully and a moment later she was swimming back to the side of the pool, her head of shortclipped auburn hair held up, straight ahead of her, as though it were a rose on a long stem." (Roth 3) He sees her only as a beautiful woman and allows that to get in the way of actually realizing the true reasons for her actions. Brenda on the other hand is using him to be her "slave." This is seen with all her actions that show that she honestly does not care about his feelings, his wants or desires. "' We'll be right back,' Brenda said to me. 'You have to sit with Julie. Carlota's off.'"(Roth 13) She finds Neil very accommodating in fulfilling her needs. Neil is constantly being thrown into predicaments for the first time, such as Brenda's country club, where Neil is viably not accustomed to being. "My next question was prompted by a desire to sound interested and thereby regain civility; it didn't quite come out as I'd expected- I said it too loud.

Foil between Mr.Darcy and Mr.Wickham

Path to Elizabeth's Heart Criticism and manners determine the image given to a person from society. The satire, â€Å"Pride and Prejudice† by Jane Austen, portrays the social life of young women who marry for love or money. The Bennet family becomes the center of attention through the conversing between Jane Bennet with Mr. Bingley, and Elizabeth Bennet with Mr. Darcy. Women married the wealthy for security and fortunate living. However, the men devise their own ways of courting women. Mr.Wickham and Mr. Darcy become foils of each other, through their many acquaintances with Elizabeth. First impressions create prejudice of a person, which cannot be easily changed. Elizabeth’s first encounter with Mr. Darcy is during a ball, â€Å"Mr. Darcy soon drew the attention of the room by his fine, tall, handsome features, noble mien†¦ the gentlemen pronounced him to be a fine figure of a man† (6). His physical features reflects his wealth, as well as the description o f a fine figure of a man.However, his physical features were not the only characteristics that were revealed during their first encounter, â€Å"his manners gave a disgust which turned the tide of his popularity; for he was discovered to be proud, to be above his company† (6). Mr. Darcy’s conversations with strangers were turned into declarations of superiority and detestment. Elizabeth saw this as a ungentlemanly manner which lead her to hate Mr. Darcy on her first encounter with him that night. Mr.Wickham on the other, â€Å"was the happy man towards whom almost every female eye was turned and the agreeable manner in which he immediately fell into conversation†¦ that the commonest, dullest, most threadbare topic might be rendered interesting† (52) Elizabeth also notices Mr. Wickham’s charm to making friends as well as his gentlemanly manner of conversing with others. She also takes an interest in what Mr. Wickham has to say, due to the conformation al bias of Mr. Wickham’s history with Mr. Darcy supporting her opinion of Mr. Darcy.She instantly trusts Mr. Wickham only because of his  manners and first impression of being of good manners. Mr. Darcy also states that, â€Å"Mr. Wickham is blessed with such happy manners as may ensure his making friends† (63). Mr. Wickham is agreeable but he also has no interest in the poor, because he only makes friends with those that will benefit him at the moment, and cast aside anyone who has played their part. The contrast between the men creates irony, because she she eventually marries the man whom she detest at first rather than the man who was agreeable at first. However, her impression on him changes once she receives the letter from Mr.Darcy. He reveals Mr. Wickham’s true nature during his visit in Pemberley was, â€Å"unquestionably my sister's fortune, which is thirty thousand pounds; but I cannot help supposing that the hope of revenging himself on me was a s trong inducement. †(137) This changes Elizabeth’s impression on Mr. Wickham and it influences her to review all that she had thought and said to Mr. Darcy. She states that she did not understand herself any more, causing her to realize the mercenary attention Mr. Wickham had given to Miss King. She could not call upon the traits to defend Mr. Wickham besides his manners.The roles of Mr. Wickham and Mr. Darcy have switched, Elizabeth visits Pemberley and reunites with Mr. Darcy, â€Å"they soon drew from those enquiries the full conviction that one of them at least knew what it was to love†¦ overflowing with admiration was evident enough,†(175). Revealing the true feelings that Elizabeth has for Darcy and the evident admiration from Darcy, Austen portrays an ideal love scene from the dreams of a woman during the era. The foils of Mr. Darcy and Mr. Wickham emphasises the prejudice of society and first impressions which cover the truth. The history between Mr. Darcy and Mr.Wickham display a forked path to their own personalities. Mr. Wickham was the son of Mr. Darcy’s father’s steward who was â€Å"of a very respectable man, who had for many years the management of all the Pemberley estates,† (135). The juxtaposition of being the son of the lord and the son of the steward who worked under him, displays the contrast of Mr. Darcy’s and Mr. Wickham’s personalities. Darcy would have been educated by his father or schooling, and thus he spent years alone, with his sister, after his father died, meanwhile Wickham learned his manners from being a steward under Pemberley.Their own paths formed the personalities which they have become. Another example appears within Darcy’s letter, Mr. Wickham â€Å"had some intention†¦ of studying the law, and I must be aware that the interest of one thousand pounds would be a very insufficient support therein† (136). The legacy of one-thousand pounds that Mr. Darcy’s father left to Wickham was not enough to allow Wickham to survive through is years. Darcy gives Wickham three-thousand goals to allow Wickham to attend law school, however the law soon declined and was not a profitable field to enter.Coming back to Darcy for assistant, Wickham gets denied of money. Wickham seeking vengeance, â€Å"he so far recommended himself to Georgiana, whose affectionate heart retained a strong impression of his kindness to her as a child, that she was persuaded to believe herself in love, and to consent to an elopement† (137). Wickham was after the fortune on Miss Darcy as revenge for not helping him through his years of distress. Contrast between evil intentions and pure hearts exposes the satire behind Austen’s writing.The irony of falling in love with a corrupted man while being pure at heart, emphasises blinding love. Darcy’s and Wickham’s history with each other reveals the different paths which both of them tak e. Jane Austen expresses her views of social life of the poor and the wealthy through Darcy’s and Wickham’s first impression on Elizabeth. Her prejudice and pride blinds her from realizing the truth behind Darcy and Wickham. The foils of the agreeable Wickham and discerning Darcy, portrays society as a loveless defect with only money on their minds. Foil between Mr.Darcy and Mr.Wickham Path to Elizabeth's Heart Criticism and manners determine the image given to a person from society. The satire, â€Å"Pride and Prejudice† by Jane Austen, portrays the social life of young women who marry for love or money. The Bennet family becomes the center of attention through the conversing between Jane Bennet with Mr. Bingley, and Elizabeth Bennet with Mr. Darcy. Women married the wealthy for security and fortunate living. However, the men devise their own ways of courting women.Mr.  Wickham and Mr. Darcy become foils of each other, through their many acquaintances with Elizabeth. First impressions create prejudice of a person, which cannot be easily changed. Elizabeth’s first encounter with Mr. Darcy is during a ball, â€Å"Mr. Darcy soon drew the attention of the room by his fine, tall, handsome features, noble mien†¦ the gentlemen pronounced him to be a fine figure of a man† (6). His physical features reflects his wealth, as well as the descriptio n of a fine figure of a man.However, his physical features were not the only characteristics that were revealed during their first encounter, â€Å"his manners gave a disgust which turned the tide of his popularity; for he was discovered to be proud, to be above his company† (6). Mr. Darcy’s conversations with strangers were turned into declarations of superiority and detestment. Elizabeth saw this as a ungentlemanly manner which lead her to hate Mr. Darcy on her first encounter with him that night.Mr. Wickham on the other, â€Å"was the happy man towards whom almost every female eye was turned and the agreeable manner in which he immediately fell into conversation†¦ that the commonest, dullest, most threadbare topic might be rendered interesting† (52) Elizabeth also notices Mr. Wickham’s charm to making friends as well as his gentlemanly manner of conversing with others. She also takes an interest in what Mr. Wickham has to say, due to the conformat ional bias of Mr. Wickham’s history with Mr. Darcy supporting her opinion of Mr. Darcy.She instantly trusts Mr. Wickham only because of his  manners and first impression of being of good manners. Mr. Darcy also states that, â€Å"Mr. Wickham is blessed with such happy manners as may ensure his making friends† (63). Mr. Wickham is agreeable but he also has no interest in the poor, because he only makes friends with those that will benefit him at the moment, and cast aside anyone who has played their part. The contrast between the men creates irony, because she she eventually marries the man whom she detest at first rather than the man who was agreeable at first. However, her impression on him changes once she receives the letter from Mr. Darcy.He reveals Mr. Wickham’s true nature during his visit in Pemberley was, â€Å"unquestionably my sister's fortune, which is thirty thousand pounds; but I cannot help supposing that the hope of revenging himself on me was a strong inducement. †(137) This changes Elizabeth’s impression on Mr. Wickham and it influences her to review all that she had thought and said to Mr. Darcy. She states that she did not understand herself any more, causing her to realize the mercenary attention Mr. Wickham had given to Miss King. She could not call upon the traits to defend Mr. Wickham besides his manners.The roles of Mr. Wickham and Mr. Darcy have switched, Elizabeth visits Pemberley and reunites with Mr. Darcy, â€Å"they soon drew from those enquiries the full conviction that one of them at least knew what it was to love†¦ overflowing with admiration was evident enough,†(175). Revealing the true feelings that Elizabeth has for Darcy and the evident admiration from Darcy, Austen portrays an ideal love scene from the dreams of a woman during the era. The foils of Mr. Darcy and Mr. Wickham emphasises the prejudice of society and first impressions which cover the truth. The history between M r. Darcy and Mr. Wickham display a forked path to their own personalities.Mr. Wickham was the son of Mr. Darcy’s father’s steward who was â€Å"of a very respectable man, who had for many years the management of all the Pemberley estates,† (135). The juxtaposition of being the son of the lord and the son of the steward who worked under him, displays the contrast of Mr. Darcy’s and Mr. Wickham’s personalities. Darcy would have been educated by his father or schooling, and thus he spent years alone, with his sister, after his father died, meanwhile Wickham learned his manners from being a steward under Pemberley.Their own paths formed the personalities which they have become. Another example appears within Darcy’s letter, Mr. Wickham â€Å"had some intention†¦ of studying the law, and I must be aware that the interest of one thousand pounds would be a very insufficient support therein† (136). The legacy of one-thousand pounds that Mr. Darcy’s father left to Wickham was not enough to allow Wickham to survive through is years. Darcy gives Wickham three-thousand goals to allow Wickham to attend law school, however the law soon declined and was not a profitable field to enter.Coming back to Darcy for assistant, Wickham gets denied of money. Wickham seeking vengeance, â€Å"he so far recommended himself to Georgiana, whose affectionate heart retained a strong impression of his kindness to her as a child, that she was persuaded to believe herself in love, and to consent to an elopement† (137). Wickham was after the fortune on Miss Darcy as revenge for not helping him through his years of distress. Contrast between evil intentions and pure hearts exposes the satire behind Austen’s writing.The irony of falling in love with a corrupted man while being pure at heart, emphasises blinding love. Darcy’s and Wickham’s history with each other reveals the different paths which both of them take. Jane Austen expresses her views of social life of the poor and the wealthy through Darcy’s and Wickham’s first impression on Elizabeth. Her prejudice and pride blinds her from realizing the truth behind Darcy and Wickham. The foils of the agreeable Wickham and discerning Darcy, portrays society as a loveless defect with only money on their minds.

Pay for Performance Essay

Prior to the 2000s, fee-for-service systems dominated how health care providers received payment for providing care to patients. Under the fee-for-service system, physicians received payments, according to the volume of patients and the complexity of services. Two reports written by the Institute of Medicine clearly substantiated serious deficiencies in the quality of health care in the United States. The findings prompted the need to develop initiatives to pay health care workers based on quality. The following discussion defines pay-for-performance, explains the effects of reimbursement under this approach, details the impact of system cost reductions on the quality and efficiency of health care, the effects of this model on health care providers and customers, and the effect pay-for-performance will have on the future of health care. The Definition of Pay for Performance Pay for performance models reward providers, such as physicians, other health care providers, hospitals, and medical groups under contract for meeting pre-established performance measures to improve quality and efficiency in health care delivery. It is popular among policy makers and private and public payers, such as Medicare and Medicaid. The first initiative adopted by one of the nation’s largest health care plans, PacifiCare Health Systems, began paying medical groups in California bonuses for meeting or exceeding 10 clinical and service quality targets in 2003 (Meredith, Richard, Zhonghe, & Arnold, 2005). Service quality targets included five patient-reported measures of service quality, five ambulatory care quality indicators, and a set of hospital quality measures for referring patients to high-quality hospitals. The criteria in the first year required medical groups to acquire a minimum of 1000 PacifiCare Commercial and 100 Secure Horizons enrollees. Research showed the network of California medical groups, under contract to improve performance goals, outweighed the performance measure of another medical group not under contract, Pacific Northwest, for cervical cancer screening by a significance of 3.6%. Of 163 eligible physician groups, 97 (60%) received a distribution of funds from the program related to at least 1 physician group quality performance target in the first quarter of the QIP. In the last payout based on the original set of targets (April 2004), 129 of 172 (75%) groups reached at least 1 physician group quality target. (Meredith, Richard, Zhonghe, & Arnold, 2005, para. 26) Only 14 medical groups exceeded more than half of the performance targets. The pay-for-performance approach showed an inverse relationship where physician groups with lower performance improved the most whereas physician groups that previously achieved target goals improved the least. The Effects of Reimbursement under Pay for Performance The article Early Experience With Pay-For-Performance: From Concept to Practice (Meredith, Richards, Zhonghe, & Arnold, 2005) argues this approach to improving the quality of care fulfills multiple objectives. One positive impact of pay-for-performance suggests paying health care providers for meeting certain quality indicators increases performance. The authors claim low-performing health care providers improved because they viewed the landscape of health care delivery changing by the mounting pressure of payees to improve their health care systems and decided to remain in good standing. Low-performing health care providers contend they cannot achieve benchmark levels of performance because of barriers beyond their control, such as limited resources or low-socioeconomic, patient populations. A negative impact of pay-for-performance indicates high-performing health care providers meeting target levels have no incentive to improve their performance and thus offer status quo health care services to their patients. Another reason health care providers have no incentive to produce services beyond the norm indicates low rewards paid by insurance networks. â€Å"Paying for improvement fails to reward and even penalizes providers that have already achieved high levels of health care quality at the time a pay-for-performance program is initiated† (Meredith, Richards, Zhonghe, & Arnold, 2005, para. 32). For the reasons stated above, the distribution of rewards primarily goes to the group of providers with low-performing standards and increases the impact of pay-for-performance. Impact of System Cost Reductions on Quality and Efficiency of Health Care Evidence of pay-for-performance shows mixed results. One study, Premier Hospital Quality Incentive Demonstration, performed by Rachel M. Werner of the University of Pennsylvania, compared the improvements in quality for hospitals paid incentives to a control group of hospitals who did not receive incentives from 2004 – 2008. The results reflected minor significance in improvement in the quality and efficiency of health care. In fact, diminishing returns occurred after the fifth year (Health Policy Brief, 2012)(See Figure 1). Other pay-for-performance initiatives, such as the Medicare Premier Hospital Quality Incentive, rolled out at the same time as Werner’s study, which analysts profess as the reason behind the improvement in quality and efficiency of health care among hospitals. Like health care providers, hospitals did not want to endure the embarrassment of presenting an image lacking in quality care. They sought to clean up their acts in anticipation of the Centers for Medicare and Medicaid Services (CMS) implementing pay-for-performance measures in health care. A project conducted between 2005 and 2010, the Medicare Physician Group Practice Demonstration, focused on quality and cost. Researchers of Dartmouth College and the National Bureau for Economic Research analyzed doctors, who would receive bonuses for achieving lower cost growth and meeting quality targets, in 10 large physician group practices. They found improvement in the quality of care but little reduction in the growth of spending for most Medicare patients (Health Policy Brief, 2012). Effects on Health Care Providers and Customers Health care providers agree with the need to improve quality of care but have concerns with pay-for performance. It takes money to implement, maintain, and document quality measures. They reason if payees give modest payments as incentives, they cannot recoup additional administrative costs and provide quality care simultaneously. Others fear the implementation of health information technology for data collection and reporting will close the doors of their practices. The American Medical Association (AMA) believes providers should have the choice to volunteer in incentive programs, review, comment, and appeal performance data, and receive payment for participating (Health Policy Brief, 2012). Another issue health care providers have with this cost containment model lies on the premise that hospitals that care for patients from low-income backgrounds bear the burden of lower improvement scores compared to hospitals that care for patients from mid-level to high-level incomes. Lower improvement scores result from low-income patients’ lack of transportation, language barriers, and childcare among other barriers to access health care services. Limited access to care halts the prevention and treatment of chronic illnesses and increases readmission rates of patients to hospitals. As a result, hospitals incur penalties. Health care providers concerned with the impact these arrangements have on patients, oppose these programs because they think patient care will weaken at the expense of cost containment. Physicians have the power to control their pay by hand-picking the best patients to maintain or increase their performance measures. By selecting healthier patients, physicians widen the gap for racial and ethnic disparities in health care delivery. A study by Jha and colleagues of costs and quality in US hospitals found a group that consistently performed worse on both quality and cost metrics and that cares for proportionally greater numbers of elderly black and Medicaid patients than other institutions. (Health Policy Brief, 2012, para. 42) In comparison, a Yale study showed safety-net hospitals outperformed hospitals that treated less proportionate numbers of low-income patients. Effects on the Future of Health Care The implementation of the Affordable Care Act (ACA) will increase the need for pay-for-performance programs and incentives. The Affordable Care Act promises to increase the enrollment of Medicaid and Medicare patients. Health care workers will find challenges with a large generation of Baby Boomers who will need long-term care. Under the ACA health care providers’ scores will include indicators, which measure patient-centered care, family engagement, and the ability to address disparities in health care delivery. As well, under the ‘Value-Based Purchasing Incentive’ mandates of the ACA, the Centers for Medicare [and] Medicaid Services have not only proposed additional process-of-care quality and mortality outcome measures on which to base future payments but also an integration of patient experience scores, representing up to 30% of hospital incentive payments, financially penalizing those with low scores. (Liang & Mackey, 2011, p. 1427) Not only that but also hospitals will have to report efficiency measures to include Medicare spending per beneficiary. Mandates will not only require quality but also focus on reducing costs. New programs will measure the reduction of costly hospital readmissions, restrict Medicaid payments for hospital-acquired conditions, and reduce Medicare payments to hospitals with the highest rates of medical harm. Conclusion Reports and studies support evidence, which shows pay-for-performance does not improve the quality of care nor reduce the costs of health care. Researchers must find ways to improve quality of care over a substantial period, close racial and economic disparity gaps, and increase health care worker acceptance of pay-for-performance programs, and incentives, which motivate providers to produce more positive health outcomes. Developers of program incentives should use tools, which help monitor and evaluate health care outcomes aside from other factors with variations in health care markets. By collecting data, researchers can design programs that improve quality of care and reduce costs. References Health Policy Brief: Pay-for-Performance. (2012, October 11). Health Affairs. Retrieved from http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=78 Liang, B. A., & Mackey, T. (2011). Quality and Safety in Medical Care: What Does the Future Hold?. Archives Of Pathology & Laboratory Medicine, 135(11), 1425-1431. doi:10.5858/arpa.2011-0154-OA Meredith, B. R., PhD, Richard, G. F., PhD, Zhonghe, L., MA, & Arnold, M. E., MD, MA. (2005). Early experience with pay-for-performance: From concept to practice. The Journal of the American Medical Association, 294(14), 1788–1793. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=201673 Shaman, H. (2008). What you need to know about pay for performance. Hfm (Healthcare Financial Management), 62(10), 92-96.