Monday, August 24, 2020

Grading System Indian education system

The Indian instruction framework has stepped forward towards restoring the training framework with the presentation of reviewing framework in meeting 2009-10. It will help in decreasing the weight on understudies during tests. Over the most recent five years the importance of training has changed for understudies from soaking up information to only scoring marks, bringing about heap types of instruction approaches. According to reports, each day in excess of 17 understudies matured between 15-25 years end it all in India due to non-execution in the assessment or a passage test.Watching little youngsters of the nation capitulating to the undue weight of scoring good grades is sickening. One of the focuses to note here is the thinking about the general public, which squeezes understudies to ‘to perform'. This weight from schools, guardians, peer gatherings and society removes the energy of a youngster. Further, a wellbeing report likewise underpins this frequently causes wellbein g risk, for example, weariness, body hurts, eye shortcoming, stress and in increasingly extreme cases, discouragement (hypochondriac/insane. Taking a gander at the present instruction situation, the Central Board of Senior Education has presented instructive advocates and youngster clinicians in schools to support the certainty of youthful understudies and intellectually set them up for the board assessment. This strategy has helped in diminishing the pressure and making them OK with the assessment. Understanding the load up test framework in India and its connection with understudies is vital in present occasions. While adapting to the desires for school, guardians and society and staying up with their ability, understudies face a great deal of hardships.Thus, the execution of an evaluating framework and nullification of board tests is actually a shelter for understudies. Appropriation of reviewing framework in India, the evaluating framework was presented in 2008-09 from class I-V III, diminishing the test pressure. Stretching out the idea to class IX and X has additionally decreased the weight, allowing understudies a chance to investigate different roads. Following the US model, the usage of the reviewing framework is to acquire more down to earth training than the current hypothetical method.This model endorses a differed scope of chances, giving offspring of all levels a stage to exhibit their ability and seek after their inclinations generally; class XI understudies were given subjects according to marks scored in Class X. This framework regularly disillusioned understudies in the event that they scored low. Additionally, if an understudy didn't get the necessary rate because of poor scoring in one subject, at that point the whole rate gets influenced. The reviewing framework will give understudies alleviation. It will give adequate chances to understudies to exceed expectations in their decision documented. Evaluating System Indian instruction framework The Indian training framework has stepped forward towards restoring the instruction framework with the presentation of reviewing framework in meeting 2009-10. It will help in decreasing the weight on understudies during tests. Over the most recent five years the importance of instruction has changed for understudies from assimilating information to simply scoring marks, bringing about bunch types of training strategies. According to reports, each day in excess of 17 understudies matured between 15-25 years end it all in India due to non-execution in the assessment or a passageway test.Watching small kids of the nation surrendering to the undue weight of scoring excellent grades is stunning. One of the focuses to note here is the thinking about the general public, which squeezes understudies to ‘to perform'. This weight from schools, guardians, peer gatherings and society removes the energy of a kid. Further, a wellbeing report likewise bolsters this frequently causes wellbeing risk, for example, weariness, body throbs, eye shortcoming, stress and in increasingly extreme cases, wretchedness (hypochondriac/maniacal. Taking a gander at the present training situation, the Central Board of Senior Education has presented instructive advisors and kid clinicians in schools to help the certainty of youthful understudies and intellectually set them up for the board assessment. This technique has helped in decreasing the pressure and making them OK with the assessment. Understanding the load up test framework in India and its connection with understudies is critical in present occasions. While adapting to the desires for school, guardians and society and staying up with their ability, understudies face a great deal of hardships.Thus, the execution of an evaluating framework and abrogation of board tests is actually an aid for understudies. Reception of evaluating framework in India, the reviewing framework was presented in 2008-09 from class I-VIII, diminishing the test pressure. Stretching out the idea to class IX and X has additionally diminished the weight, allowing understudies a chance to investigate different roads. Following the US model, the execution of the reviewing framework is to acquire more useful training than the current hypothetical method.This model recommends a changed scope of chances, giving offspring of all levels a stage to feature their ability and seek after their inclinations customarily; class XI understudies were given subjects according to marks scored in Class X. This framework regularly frustrated understudies on the off chance that they scored low. Additionally, if an understudy didn't get the necessary rate because of poor scoring in one subject, at that point the whole rate gets influenced. The reviewing framework will give understudies alleviation. It will give plentiful chances to understudies to exceed expectations in their decision documented.

Saturday, August 22, 2020

Mans Search for Meaning by Viktor E. Frankl :: Papers

Man's Search for Meaning by Viktor E. Frankl By and large, just those detainees could keep alive who, following quite a while of trekking from camp to camp, had lost all compunctions in their battle for presence; they were set up to utilize each mean, fair and something else, even merciless power, robbery, and disloyalty of their companions, so as to spare themselves. We who have returned, by the guide of numerous fortunate possibilities or marvels - whatever one may decide to call them - we know: the best of us didn't return. (p. 7) The Three Phases of the Inmate's Mental Reactions to Camp Life: a) the period following his affirmation Side effect = stun Dream of respite: The censured man, preceding his execution, gets the hallucination that he may be reprieved at the last possible second. We, as well, clung to the smidgens of expectation and accepted to the last second that it would not be so terrible. (p. 14) 1) a bleak comical inclination 2) cold interest 3) considerations of self destruction An unusual response to an anomalous circumstance is typical conduct. (p. 30) b) The period when he is all around settled in camp daily schedule a) Relative lack of concern, a sort of passionate demise Disturb, awfulness and pity were feelings one could not so much feel any longer. The victims, the withering and the dead, turned out to be such ordinary sights to him following half a month of camp life that they couldn't move him any longer. (p. 33) ...the detainee before long encircle himself with an important defensive shell. (p. 35). b) Extreme yearning from undernourishment and distraction with food c) Absence of sexual inclination d) Social hibernation, with the two special cases: governmental issues and religion Regardless of all the implemented physical and mental crudeness of life in a death camp, it was workable for otherworldly life to develop. Delicate individuals who were utilized to a rich scholarly life may have endured a lot of agony (they were regularly of a sensitive constitution), however the harm to their internal identities was less. They had the option to withdraw from their horrible environmental factors to an existence of inward wealth and profound opportunity. (p. 56). On adoration while thinking on his better half while walking: ...for the first run through in my life I considered the to be as it is set into melody by such a significant number of artists, declared as the last astuteness by so numerous masterminds. Reality - that affection is a definitive and the

Monday, July 20, 2020

Questions to Ask Yourself After a Preliminary Diagnosis

Questions to Ask Yourself After a Preliminary Diagnosis Phobias Symptoms and Diagnosis Print 5 Questions to Ask Yourself After an Initial Diagnosis How an Initial Diagnosis Isnt Always Correct By Lisa Fritscher Lisa Fritscher is a freelance writer and editor with a deep interest in phobias and other mental health topics. Learn about our editorial policy Lisa Fritscher Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 27, 2020 Blend Images - Ned Frisk / Brand X Pictures / Getty Images More in Phobias Symptoms and Diagnosis Causes Treatment Types While not an official clinical term, the phrase “initial diagnosis” or preliminary diagnosis, is sometimes used informally to refer to the diagnosis that a client receives after an intake interview. Psychological disorders can be complex and difficult to accurately diagnose, but many insurance companies require an immediate diagnosis to pay for treatment. However, after receiving an initial  diagnosis from a physician, its important to verify that you, in fact, are suffering from this condition. The initial diagnosis is often correct, but many therapists caution their clients that the diagnosis may change after further sessions. There are many cases of misdiagnosis, especially in the mental health field where one disorder or phobia can have very similar symptoms and causes. A very basic example of misdiagnosis  would be a doctor saying you have the flu, when in fact, you only have a viral infection. 5 Questions to Ask Yourself For this reason, you want to take the proper steps toward treating your condition. Here are a few questions to ask yourself: Do I want to get a second opinion? If you are being  diagnosed with a serious medical or psychological disorder its important to seek a second opinion, as some  diagnosis can be subjective.Do I need a specialist? Make sure the doctor who is providing the diagnosis is qualified to do so. In the case of psychological disorders, this diagnosis is best provided by a mental health professional.Do I need to submit this diagnosis to my insurance company? Your initial diagnosis may be important to your insurance company, but may not always be correct. If your insurance policy allows, it may be wise to wait for a final diagnosis before submitting it to your insurance company.Am I covered for further testing and treatment? Even before you submit the diagnosis to your insurance company you may want to speak to a human resource professional at your company to determine what is and isnt covered under your plan, and whether you need authorizations or special approvals going forward.Do I have any r eason to believe Ive been misdiagnosed? There are countless cases of misdiagnosis for a variety of reasons. This is why seeking a second opinion is important.

Thursday, May 21, 2020

Internal Marketing And Organizational Behavior Essay

Customer service is the most important part of a hotel based organization, it also forms the most competitive advantage and a critical element in internal marketing. Moreover it also has influences in other industries as well. Internal marketing is based on the internal communication and treating powers of employees as well as customers. Implementing internal marketing includes educating, stimulating, guiding and leading workforce to improve quality and performance. The service employees represents the organization to the customers, do to which the role of employees is both complex and multi-dimensional. The internal marketing is the study to improve marketing and organizational behavior and literature study.it also focuses on importance of employees in service encounters with the understanding of internal marketing. Customer satisfaction is the most important gadget which makes the organization makeable, survive and face competition. The concept of internal marketing is the upcoming topic and it creates an attention amongst the researchers. The term internal marketing has been focused on two parts i.e. Employees (internal market) and customers (external market) to provide services and conduct the business. It has been recognized in a hotel industry, they are the customers who make the hotel industry grow or vanish. The research we have selected is internal marketing in hotel industry. The main reason to investigate on workers, who are satisfied with the attitude of theShow MoreRelatedDecision-Making Factors1136 Words   |  5 Pages as well as the future of the organizational staff members and its partners. In this setting, it is of the utmost importance for decisions to be made in a clear manner, in which they consider the totality of factors involved. 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The 7 S Framework created by two consultants, Tom Peters and Robert Waterman from the McKinsey Company, which uses an internal alignment perspective to improve organization effectiveness (Caraballo, 2015). The McKinsey 7 S model helps strategic managers create and maintain efficient alignment (Dyer, Godfrey, Jensen, Bryce, 2016). According to Singh (2013) indicated theRead MoreManagement, Organizational Behavior, And The Systems Theory963 Words   |  4 Pagescan be hard to find the right balance and then maintain that balance but contemporary approaches to management aim to do just that. The sociotechnical theory, quantitative management, organizational behavior, and the systems theory all work in different ways to maintain a sort of balance within the businesses internal, competitive and macroenviroments. Keeping all areas of the open system balanced is essential for any manager to have a successful busin ess. 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Wednesday, May 6, 2020

What I Did The Baylor Interdisciplinary Curriculum ( Bic )

There were many ways I could have gone about writing this essay, the needless use of big words to convey simple points, the insertion of irrelevant long quotes just to make the minimum page requirement, but this is the last undergraduate essay I will ever write. If I will write, I might as well write with my best effort and in my own style. Reflecting over my journey these last five years has been difficult. These years have been filled with so many trials and tribulations that it feels as though a lifetime has passed since I first set foot on the campus of Baylor University, yet at the same time it feels as though it went by so fast, I merely blinked and it was over. I can honestly say the Baylor Interdisciplinary Curriculum (BIC) is my greatest and most precious takeaway from my undergraduate experience. It was in the BIC that I learned to enlarge my perspective, become more fully aware of myself, and become prepared for leadership and service. I have been challenged by the BIC and to my surprise, I rose to the challenge. This experience cannot be fully explained without evaluating and reflecting upon the various worlds, lives, and cultures explored in the BIC and how they are personally related to me. The BIC educated me on the ‘World of Rhetoric’ and from that experience I gained profound oratory and writing skills that I will utilize the rest of my life. Out of all the concepts I have studied in the BIC, the ‘World of Rhetoric’ was by far the most jarring and

Night Creature Blue Moon Chapter 25 Free Essays

By the time my shift was over and the sun had risen on another day, I’d decided to name the game â€Å"pandemonium.† We’d had four arrests, three accidental shootings, two dead dogs – â€Å"And a partridge in a pear tree,† I muttered as I filled out my reports. I’d never had a chance to meet with Mandenauer. We will write a custom essay sample on Night Creature: Blue Moon Chapter 25 or any similar topic only for you Order Now Hunting would have been pointless anyway, since the woods were overrun with morons. Amazingly, not a wolf had been shot. I had to wonder if they’d all turned tail and run to the next county. It wouldn’t break my heart any. I was also unable to meet Cadotte. I’d called his house, but he wasn’t there, so I left a short, apologetic message. I suspected he was at my place, and I felt kind of bad that I’d left him sitting on my doorstep. But I couldn’t leave just yet. He knew where to find me. As I was looking through my notes, I discovered that while I might thrive on third shift, my memory did not. I’d forgotten about Tina Wilson. I decided to stop by her apartment later today, if not tonight. My days of working in the dark and sleeping in the light appeared to be over – for the duration of our wolf problem. â€Å"Ha!† The door slammed. Everyone in the room – me, First Shift, Brad, several of the Clearwater cops – jumped. Clyde held a legal-sized sheet of paper in his fist. â€Å"Got it,† he told the room at large. We glanced at one another, then back at him. â€Å"Got what?† I asked. â€Å"A proclamation from the DNR.† â€Å"What’s it say?† â€Å"Any private citizen caught in the woods with a gun will lose their license for a year.† â€Å"Ouch,† I murmured. Clyde just smiled. While folks in and around Miniwa wouldn’t blink at a few days in jail for illegal firearms transportation, threatening to take away their hunting and fishing privileges – which was the DNR’s specialty – would make people sit up and take notice. â€Å"Post this at the Coffee Pot.† He handed the paper to Brad. â€Å"Then put out the word.† Which meant get some coffee, gas up your squad car, have a doughnut, and while you were at it, let everyone know that the DNR was behind us. The woods were going to be more deserted than a ski hill on the Fourth of July. â€Å"This time tomorrow everything should be back to normal.† Clyde went into his office and shut the door. Great. Now he was delusional, too. Had he forgotten the wolf problem? As everyone dispersed to spread the news, I knocked on Clyde’s door. â€Å"Come!† I went in. â€Å"What’s up, Jessie?† Clyde’s grin didn’t mask the cir-cles under his eyes, the pallor beneath his tan, the sag of his shoulders. He hadn’t forgotten the wolf problem. In fact, he probably remembered it better than I did. Especially when I was in Cadotte’s arms, where I forgot everything. I straightened and got down to business. â€Å"I wasn’t able to go out with Mandenauer last night.† â€Å"Of course not. That would have been suicide. Edward and I had dinner.† â€Å"Edward?† He ignored me. â€Å"We also had quite a conversation.† From the narrowing of Clyde’s eyes, I knew what was coming. â€Å"Didn’t I tell you Cadotte was trouble?† â€Å"Yes, sir.† â€Å"Yet you’re sleeping with him?† â€Å"How the hell did you know that?† He raised one dark eyebrow. â€Å"I didn’t.† Damn Clyde. He was the best interrogator on the force – and he’d just played me like a green kid with her first felony. â€Å"Jessie.† He shook his head and sat on the edge of his desk. â€Å"I thought better of you.† I lifted my chin. â€Å"I haven’t done anything wrong. I’m an adult. So is he.† â€Å"You find that totem yet?† I blinked at the sudden change of subject. As if the stone had heard us, it swayed between my breasts. I jumped, then had to clench my ringers into fists to keep from reaching for the thing and rousing Clyde’s suspicions. â€Å"No. Why?† â€Å"Ever ask Cadotte about it?† â€Å"Why should I?† â€Å"I don’t know, Jessie; maybe because he’s an expert on totems. You find one, show it to him, then poof, the next thing we know, the stone is gone.† â€Å"You think he took the totem?† Since I knew he hadn’t, Clyde’s attempt to make me suspicious of Will only convinced me to keep the thing under my shirt – so to speak. â€Å"I’m not sure what to think.† Which only made two of us. Everyone was acting weird lately. Except Cadotte. But he’d been strange to begin with. My cell phone rang. I glanced at the caller ID. Speak of the Devil. 1 hooked the thing back onto my belt. Raising my eyes, I met Clyde’s. From the expression in his, he knew who’d been on the phone. He heaved a sigh. â€Å"Be careful. I don’t want you to get hurt.† Zee had said the same thing. Was I such a social reject that everyone took one look at Cadotte and labeled me â€Å"soon to be hurt†? That was a rhetorical question. A knock on Clyde’s door had us both lifting our heads. Mandenauer walked in. â€Å"Just the guy I wanted to see,† I began. He raised a slightly yellowed brow and shut the door behind him. â€Å"I am at your service.† He bowed, just his head and shoulders in what I was beginning to think of as the German fashion. I half-expected him to click his heels, but he didn’t. â€Å"The doctor at the hospital didn’t know anything about the super-rabies.† â€Å"Of course not.† â€Å"Why not? Don’t you think that’s something the doctors ought to know?† Mandenauer shrugged. â€Å"Rabies is rabies to them. The vaccine works on both.† â€Å"Not so much. Didn’t you hear that Mel died? Have you seen the body?† â€Å"Yes to both questions. Sometimes that happens.† â€Å"Well, don’t get too broken up about it,† I mumbled. â€Å"Jessie,† Clyde warned. â€Å"Yeah, yeah.† I rubbed my forehead. I was getting tired, dopey, crankier than usual. I had another question for Manden-auer – it was on the tip of my brain. â€Å"Oh!† I smacked my forehead. â€Å"Ouch.† I forced myself to lower my hand so I could see Mandenauer. â€Å"I called the CDC.† He didn’t react. â€Å"The Centers for Disease Control?† He spread his bony hands wide. â€Å"Something is funny there.† â€Å"I have never known the CDC to be very funny.† â€Å"Exactly. The first time I called, they had heard about the virus. When I called back and asked to talk to the doctor, they’d never heard of her.† Mandenauer and Clyde exchanged glances. â€Å"Sounds like someone was yanking your chain, Jessie.† â€Å"At the CDC?† â€Å"How long since you slept?† â€Å"I forget.† â€Å"Sleep.† Mandenauer turned me toward the door. â€Å"Forget about anything but ridding your forest of the wolves. Tonight we hunt at dusk.† â€Å"Dusk?† â€Å"When the sun just sets.† â€Å"I know when the hell dusk is. But why then?† â€Å"It is the time when the wolves come to life. I will be at your house an hour before that.† â€Å"Fine. Whatever.† I was starting to wonder about that first phone call to the CDC. Had someone been screwing with me? How could that be? A tap on the phone? Interception of my calls? Put me and Oliver Stone in the same padded room, thank you. How to cite Night Creature: Blue Moon Chapter 25, Essay examples

Sunday, April 26, 2020

Reimbursement and Pay-for-Performance free essay sample

There could be an impact of the health care quality and efficiency by providers getting financial rewards if they show better care for patients as well as showing quality of performance. P4P could affect the providers and customers by the measured performance, payment policy, and the involvement implementation matters. The P4P effects that will be seen in the future of health care is that the population will see that pay-for-performance will expand, especially the Affordable Care Act. Pay-for-Performance-defined A reimbursement plan that links payment to quality and efficiency as an incentive to improve the quality of health care and to reduce costs† (Shi amp; Singh, 2012). Pay-for-performance is being turned to by payers and those who make policies. The P4P initiatives objective is to reimbursement to excellence and effectiveness to increase health care quality and to decrease costs. Agencies of the government are starting programs for providers to be encouraged to encounter e xcellent values. We will write a custom essay sample on Reimbursement and Pay-for-Performance or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page When there is improvement in care and effective performance by providers, the providers may see financial rewards. It was expected that hospitals would respond to P4P incentives, but there is little evidence that this has happened. The Affect of Pay-for-Performance on Reimbursements The objective of the pay-for-performance is to improve the quality of care from incentives for providers to be awarded by showing better performance and better quality of care. P4P changes the monetary incentives that sway providers. It should reflect the current incentives that would strengthen or put off the services that are delivered. Some health care treatments and procedures compensated more liberally than other services. P4P can be said as a program to make right some incentives that are misrepresented that many occur in the reimbursement delivery. Some pay-for-performance programs are trying to reassure readjustment of providers’ priorities to prevention. There are some tests, such as screening, that have been under reimbursed to providers. This can have an emotion impact the quality of care, but there is much to learn by the payers on how to get the quality of care effectively. The payers face some challenges. They have to deal with patients who are severely ill or patient’s behaviors, and still give high-quality care. Pay-for-performance could take away some distortions that come about by the primary arrangement of the existing imbursement structure. This could assist in changing health care delivery on the serious aspects of the residents’ health. Health Care System Cost Reductions Impacts the Quality and Efficiency Cost reduction could impact the quality and efficiency of health care by using information technology (IT). It was a federal policy initiative to increase the outcome of patient’s health (Jacobs, 2012). It was for hospitals to increase the use of technology to assist to manage expenses. It ended up improving the patient’s quality of care. It also changed Medicare way of how providers were to be reimbursed. Pay-for-performance was an approach to give providers incentives to bring about a quality of performance and to increase quality of care plus reducing costs. Providers that give the economical care yet meeting the greatest specific standards, will get the biggest reimbursement (Santo, 2013). An impact also is that many providers are being near ability in their capacity to offer better care. When there is a list of subjective measures that needs to be followed for providers to be reimbursed, this only confuses and aggravates the providers. Also when providers see their reimbursement is being cut, this makes them to stop serving the severely ill patients. By stop seeing some patients, this gives them time to up the quality of care and â€Å"lower the cost at the same time† (Santo, 2013). With CMS deeming the way reimbursement is being done, many providers will refuse to take on new Medicare patients. This will have a big impact on many older adults who may have to change providers for some reason or another. As pay-for-performance is becoming more involved in health care, providers will see a drop in reimbursements. One way for hospitals to show remarkable cost savings is to format guidelines for common use without losing quality of care (VHA, 2013). P4P Affects Health Care Providers and Customers Even though P4P is to give providers incentives to give quality care and lower costs, it is still in the early stages and cannot decide whether P4P is going to be effective in lowering health care costs. Currently, providers are paid for what services they perform, even if the services were not necessary. This does not reduce costs. With P4P, providers are encouraged to minimize procedures and treatments when possible (Montgomery, 2007). With the ObamaCare, physicians and their employees responsible financially for changes that are mandatory, defined by CMS. This affects the providers by the complexity of all the changes that has to be adopted into their present practice. This can be an overwhelming task for the providers. The current responsibilities takes up much of the providers time and energy and takes them further from just treating patients, working to cure diseases, and making an actual difference in the health issues of others. Some thinks that pay-for-performance is a rearranging of the status quo (existing state or condition) and should benefit the providers’ profession and the long-term patients. With P4P being in the early stage, it cannot be predicted how P4P will impact the provided quality of care or the costs. The customers are affected by many providers refusing to accept patients who are new to Medicare. P4P is more apprehensive with how providers get paid for their services, but there probably will not be a great impact on some patients (Montgomery, 2007). It is hoped that P4P will let patients appreciate improved health care at no costs when P4P is entirely implemented. Effects on Pay-for-Performance Will Have Future Health Care In the future, pay-for-performance will probably expand through the United States with its health care. It will be more probable if ObamaCare’s Affordable Care Act is implemented. The future of P4P has many questions to be answered especially in initiatives, such as: * How large should the rewards be? * How will distributed of rewards be considered too often? * How will performance be improved? Evaluation of the P4P should account for the different distinctions in marketing of health care, such as quantity of physicians and other providers (Health Affairs, 2012). In the future, P4P programs will propose a wider variety of policy structure to announce the health care area will have institutional complications and there will be a resilient incentives need. P4P will be integrated with harmonizing quality enhancements and involvement of cost restraint. Attention on norms of professionals in the medical field, and include providers and patients. There will be measures of performance, financial incentives will be balances with both negative and positive ones, and programs that are mandatory will be looked into to be implemented to make sure of substantial improvements in both quality and costs (Cromwell, Trisolini, Pope, Mitchell and Greenwald, 2011). P4P programs will be considered to have larger impacts of achievement in the health care field. Pay-for-performance is used to the improvement of quality of care and to reduce costs of treatments and procedures. The objective of using initiatives is to encourage providers to encounter quality values and to decrease costs. This ties reimbursement to performance and providers could be motivated to perform and deliver better care on basis that are more dependable. This should decrease the costs of health care. The ObamaCare is new and the country is going through a radical change, but pay-for-performance is becoming popular in agencies such as Medicare, Medicaid, and private insurances. But physicians and other providers using incentives for performances is raising many questions. There should be considerable monitoring and assessment to recognize planned components that completely affects results. If pay-for-performance is used effectively, it could take away some of the familiar distortions that are produced by the arrangement of the way payments are done now, and offer progressed health care delivery on dire characteristics of residents’ health. Maybe the physicians and other providers would not be concerned about the measures of quality and the reimbursements that have to be modified.