Early experience with pay-for-performance: from concept to practice.

  title={Early experience with pay-for-performance: from concept to practice.},
  author={Meredith B Rosenthal and Richard G. Frank and Zhonghe Li and Arnold M. Epstein},
  volume={294 14},
CONTEXT The adoption of pay-for-performance mechanisms for quality improvement is growing rapidly. Although there is intense interest in and optimism about pay-for-performance programs, there is little published research on pay-for-performance in health care. OBJECTIVE To evaluate the impact of a prototypical physician pay-for-performance program on quality of care. DESIGN, SETTING, AND PARTICIPANTS We evaluated a natural experiment with pay-for-performance using administrative reports of… 

Pay-for-Performance and Accountability: Related Themes in Improving Health Care

  • J. Rowe
  • Medicine, Political Science
    Annals of Internal Medicine
  • 2006
Fueled by the emergence of increasingly good evidence and relentless pressure from government and private payers to provide value, the time may come when a substantial portion of physician compensation in the United States will be pay-for-performance.

Effects of Paying Physicians Based on their Relative Performance for Quality

This study demonstrates a modest effect in improving provider adherence to quality standards for a single measure of diabetes care during the early phase of a pay-for-performance program that placed physicians under limited financial risk.

Pay for Performance: An Overview of the Literature

  • Stuart E. GreeneD. Nash
  • Medicine, Political Science
    American journal of medical quality : the official journal of the American College of Medical Quality
  • 2009
This annotated bibliography is to offer a critical analysis of the current literature and an overview of the topic of P4P to educate the reader about a health care issue that may become a cornerstone of the payment system.

Pay for Performance in Health Care: Methods and Approaches

This chapter reviews issues regarding the application of quality measures in P4P programs, including conceptual frameworks for quality of care, and reviews organizations that develop and certify quality measures.

Does Pay-for-Performance Improve the Quality of Health Care?

A systematic search of the English-language literature in PubMed was conducted to find articles published between 1 January 1980 and 14 November 2005 whose main objective was to assess the use of explicit financial incentives to improve health care quality.

Pay-for-Performance in Pulmonary Medicine: Opportunity or Threat?

These strategies are participating in existing P4P programs such as Medicare’s Physician Quality Reporting System, working through professional medical associations to create quality metrics that are important to both physicians and patients, and educating the next generation of physicians about the importance of linking reimbursement to quality.

Pay-for-performance programs in family practices in the United Kingdom.

English family practices attained high levels of achievement in the first year of the new pay-for-performance contract, and a small number of practices appear to have achieved high scores by excluding large numbers of patients by exception reporting.

Measuring Quality in Pay-for-Performance Programs

By re-focusing pay for performance on quality improvement through risk reduction, this work aims to prevent patients with complex healthcare needs from becoming financial liabilities to the physician.

Public reporting and pay for performance in hospital quality improvement.

Hospitals engaged in both public reporting and pay for performance achieved modestly greater improvements in quality than did hospitals engaged only in public reporting.



What Is the Empirical Basis for Paying for Quality in Health Care?

Little evidence is found to support the effectiveness of paying for quality in health care and comparable interventions in other sectors; even in nonhealth settings, however, the literature contains mixed results onThe effectiveness of analogous pay-for-performance schemes.

Strategies To Support Quality-based Purchasing: A Review of the Evidence

This report focuses on the two types of incentives in widespread use—performance-based payment and reputational incentives arising from the public release of performance data.

Paying for quality: providers' incentives for quality improvement.

This paper examines public reports of paying for quality over the past five years and assess each of the identified programs in terms of key design features, including the market share of payers, the structure of the reward system, the amount of revenue at stake, and the targeted domains of health care quality.

Paying for quality improvement: compliance with tobacco cessation guidelines.

Paying for performance: Medicare should lead.

It is concluded that systematic changes will not come forth quickly enough unless strong financial incentives are offered to get the attention of managers and governing boards, and as the biggest purchaser in the system, the Medicare program should take the lead in this regard.

National Quality Monitoring of Medicare Health Plans: The Relationship Between Enrollees’ Reports and the Quality of Clinical Care

The pattern of associations the authors observed among some of the measures suggests that the CAHPS survey and HEDIS are complementary quality monitoring strategies and suggest that health plans that provide better access and customer service also provide better clinical care.

The impact of physician bonuses, enhanced fees, and feedback on childhood immunization coverage rates.

Bonuses sharply and rapidly increased immunization cover-age in medical records, however, much of the increase was the result of better documentation.

Paying physicians for high-quality care.

The authors believe that the idea of payment of physicians for providing high-quality care, on the basis of explicit measures of quality, is worth pursuing, but they point out important impediments and challenges to its successful implementation.