"Pay for performance" rewards doctors, hospitals, and other health care providers for attaining targeted service goals, like meeting health care quality or efficiency standards. RAND research has explored a range of policy and economic implications related to the use of pay-for-performance delivery models.
Report
Public and private sector purchasers are actively working to design value-based payment programs to achieve the goals of improved quality and more efficient use of health care resources. How these programs are designed is a complex undertaking and one that will determine the likelihood of their success.
Journal Article
Physician organizations (POs)—independent practice associations and medical groups—located in lower socioeconomic status (SES) areas may score poorly in pay-for-performance (P4P) programs.
Journal Article
This paper presents a five-point checklist to guide those who want to improve their performance reporting methods. The goal is to minimize the frequency and severity of misclassifying providers and avoid adverse unintended consequences of reporting.
Journal Article
We used patient-level quality scores from the Hospital Quality Alliance and ranked hospitals by overall quality and by racial/ethnic disparities and modeled the effects of different pay-for-performance designs on national disparity scores.
Journal Article
Under bundled payments, doctors, hospitals, and other providers share one fee for treating all aspects of a procedure such as a hip replacement or a chronic disease like diabetes. The approach should eliminate unnecessary care and improve quality, but putting it into practice is proving to be more difficult than anticipated.
Journal Article
This white paper prepared for the Agency on Healthcare Research and Quality examines methodological issues raised by the generation of public-reporting of scores for measuring health care provider performance.
Report
This paper outlines the issues, and finds merit in developing non-standard incentives, such as prizes, to support excellence in health research in addition to 'standard' performance management and routine inspection.
Report
Germany's National Association of Statutory Health Insurance Physicians is looking to develop a unified reimbursement framework that accounts for regional prices and incorporates quality indicators. Research by RAND Europe has informed the development of the quality component of the proposed framework.
Report
As the health care industry, employers, and government officials seek to control the growth of health spending, new efforts are needed to develop and refine quality-of-care and other performance measures that can assure changes will improve medical care and do not harm patients.
News Release
As the health care industry, employers, and government officials seek to control the growth of health spending, new efforts are needed to develop and refine quality-of-care and other performance measures that can assure changes will improve medical care and do not harm patients.
Journal Article
Hospitals executives hesitant about using pay-for-performance programs to reduce racial/ethnic disparities in care.
Research Brief
Effective performance-based accountability systems (PBAS) require careful attention to selecting an appropriate design for the PBAS, given the context in which it is to operate, and to monitor, evaluate, and adjust the system, as appropriate.
Report
Performance-based accountability systems (PBASs) link incentives to measured performance to improve public services. This report explores PBAS design and effectiveness in child care, education, health care, emergency preparedness, and transportation.
Report
This report describes a framework to evaluate a form of performance-based management, a performance-based accountability system, which identifies behavior changes needed to improve performance, an incentive structure, and performance measures.
Journal Article
Although pay for performance incentives are increasingly popular, the healthcare literature shows that these have had minimal effect. Design improvements in these programs can enhance their effectiveness.
News Release
Rewarding primary care physicians for providing better care to patients could end up widening medical disparities experienced by poorer people and by minorities. Increasing the number of primary care physicians is also not enough to boost U.S. health care quality and lower costs.
Journal Article
Rewarding primary care physicians for providing better care to patients could end up widening medical disparities experienced by poorer people and by minorities. Increasing the number of primary care physicians is also not enough to boost U.S. health care quality and lower costs.
Journal Article
One-liner abstract (description): Despite the popularity of pay-for-performance (P4P) among health policymakers and private insurers as a tool for improving quality of care, there is little empirical basis for its effectiveness.
Journal Article
Pay-for-performance, transparency, and other innovative ways of compensating physicians will only work if, at the same time, the system for providing care has clear objectives and specific tools to help physicians achieve those objectives.
Journal Article
Pay-for-performance incentives improve physician-patient communication, care coordination, and interaction with office staff.
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