How Do “Pay-for-Performance” Incentives Affect Quality of Care?

A large British “natural experiment” provides intriguing data and raises important questions.

“Pay-for-performance” programs have proliferated in healthcare, but their effect on quality of care is difficult to evaluate. The U.K. National Health Service introduced an extensive quality incentive program in 2004 that involved more than 150 indicators and accounted for up to 25% of the income of primary care practices. Over the years, some indicators were retired and new ones were introduced, providing a “natural experiment” that has been analyzed in previous studies to compare outcomes before and after the changes. Now, researchers have combined data from 30 such studies in a systematic review. Expected outcomes were adjusted for temporal trends that preceded each intervention.

For all indicators, outcomes improved 1 year after the intr…

Reviewing Author

Bruce Soloway, MD

Disclosures

Editorial BoardsNew RoAR News (http://www.newroarnews.org)

Bruce Soloway, MD

Disclosures

Editorial BoardsNew RoAR News (http://www.newroarnews.org)

How Do “Pay-for-Performance” Incentives Affect Quality of Care?

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Reviewing Author