Pay for Performance Doesn't Benefit Patients with Hypertension

Government and private payers promote pay for performance (PFP) as a way to improve quality of care and outcomes. Yet, few studies have been designed to assess the effects of PFP — even among patients with common conditions, such as hypertension. Using a large primary care database, U.K. investigators examined the effect of PFP on quality of care and outcomes among >470,000 patients with hypertension that was diagnosed between 2000 and 2007. The PFP financial incentive, which included quality-of-care targets for hypertensive patients, was implemented in April 2004.

PFP had no effect on mean systolic or diastolic blood pressure (BP) levels for the study population. During the 4 years before PFP implementation, the percentages of patients who …