The RAND Corporation's COMPARE initiative provides information and tools to help policymakers, the media, and others understand, design, and evaluate health care policies. The COMPARE Web site presents a range of policy options that allows the user to explore the effects of commonly proposed health care reforms.

This document explores how physician pay for performance (P4P) programs would affect health system performance along nine dimensions. How physician P4P programs would affect health care spending depends strongly on program design. Effects on the reliability with which appropriate care is provided, patient experience, and health are uncertain. P4P programs are not relevant to consumer financial risk, coverage, and capacity. Broad implementation of physician P4P is technically feasible but would require substantial investments in infrastructure and resources to support implementation and ongoing operations. Implementation would be especially challenging in small physician practices, which lack dedicated staff to help with implementation and adherence.

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