"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.
Alignment with best P4P practices varies across Medicare programs; the program for Medicare Advantage aligns most strongly. It is unclear which P4P design elements are critical for quality improvement. Unintended consequences of design features are poorly understood.
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.
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.
Pay-for-performance (P4P) programs may have unintended effects on racial/ethnic disparities.
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.
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.
Hospitals executives hesitant about using pay-for-performance programs to reduce racial/ethnic disparities in care.
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.
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.
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.
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.
Pay-for-performance incentives improve physician-patient communication, care coordination, and interaction with office staff.
Assess the robustness of patient responses to a new national survey of patient experience as a basis for providing financial incentives to doctors.
Proposals to use episodes of care as a basis for payment and performance measurement are largely conceptual at this stage, with little empirical work or experience in applied settings to guide their design.
Pay-for-performance (P4P) has been widely adopted, but it remains unclear how providers are responding and whether results are meeting expectations.
More than 40 private sector hospital pay-for-performance (P4P) programs now exist, and Congress is considering initiating a Medicare hospital P4P program. Given the growing interest in hospital P4P, this systematic review of the literature examines the current state of knowledge about the effect of P4P on clinical process measures, patient outcomes and experience, safety, and resource utilization.
Most breast cancer care providers in Los Angeles County outside of staff- or group-model HMOs are not subject to explicit financial incentives based on quality-of-care measures. New approaches are needed to direct incentives toward these specialists.
Presents the results of a targeted national effort to identify pay-for-performance programs in behavioral health. Many programs struggled to obtain accurate data on quality and outcomes of care, and public reporting of results was not widespread.
The authors found an association between P4P incentives and the use of quality improvement initiatives.
The introduction of information technology (IT) in physician organizations and practices is a source of great interest to physician leaders and policy makers.