Studies have shown that the lowest performing physicians in pay-for-performance (P4P) programs improved the most; however, it is unclear whether this would occur without the P4P program or be sustained. The objective of this study is to investigate the impact of P4P in a Preferred Provider Organization (PPO) on low performing physicians over a 4-year period. We used administrative claims data f...

BACKGROUND Pay for performance (P4P) initiatives are designed to foster and reward improvement in health care delivery. These programs promote "value-based health care" by rewarding quality care that is characterized by a reduced amount of disproportionate spending. OBJECTIVE To review the intent and design of P4P initiatives as well as the design and results of P4P programs in current practi...

Medicare has sought to improve patient care through pay-for-performance (P4P) programs that better align hospitals’ financial incentives with quality of service. However, the design of these policies is subject to a variety of practical and institutional constraints, such as the use of “small” performance-based incentives. We develop a framework based on a stylized principal-agent model to char...

BACKGROUND The impact of pay-for-performance (P4P) programs on long-term mortality for chronic illnesses, especially diabetes mellitus, has been rarely reported. Several studies described the favorable impact of P4P for diabetes mellitus on medical utilizations or intermediate outcomes. Therefore, this study aimed to investigate the impact of a P4P program on mortality in patients with type 2 d...

We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and the...

Pay-for-performance (P4P) has recently been introduced in Nigeria to improve quality of health services. Its early results show significant variation between implementation sites. Literature suggests this might be explained by differences in design, context and implementation of the scheme. This study aimed to explore how context and implementation influence P4P in Nigeria. Semi-structured in-d...

document when you quote from it. You must not sell the document or make a profit from reproducing it. Chapter 4 Concerns about quality of care have accelerated since the 1990s, as studies by Wennberg, Fisher, and others have documented large and unexplained variations in rates of health care utilization and clinical outcomes across geographic areas, calling into question the traditional approac...

OBJECTIVE Describing the extent and forms of use of pay for performance (P4P) in Colombian healthcare. METHODS This was a descriptive study based on interviews and surveys of health insurance agency managers in Bogotá, Colombia. The authors relied on transaction cost theory to interpret the results. RESULTS P4P was found to be used by contribution scheme insurers in an outpatient setting, b...

Pay for performance (P4P) is becoming increasingly popular in the health care sector as a tool for encouraging performance (especially quality) improvement. Evidence about the effect of policies in hospitals is rare and generally confined to developed countries. The Iranian hospital grading system, which links the charges hospitals can make for patient stay to the results of their annual perfor...

Pay-for-performance (P4P) programs have the potential to improve overall quality of care by narrowing gaps between what national care guidelines recommend and those treatments actually delivered in routine community practice. P4P is also viewed as a tool to promote more efficient use of healthcare resources while improving patient outcomes. P4P provides financial incentives for quality of servi...