Key issues in the design of pay for performance programs. 2013

Frank Eijkenaar
Institute of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3000 DR Rotterdam, The Netherlands. eijkenaar@bmg.eur.nl

Pay for performance (P4P) is increasingly being used to stimulate healthcare providers to improve their performance. However, evidence on P4P effectiveness remains inconclusive. Flaws in program design may have contributed to this limited success. Based on a synthesis of relevant theoretical and empirical literature, this paper discusses key issues in P4P-program design. The analysis reveals that designing a fair and effective program is a complex undertaking. The following tentative conclusions are made: (1) performance is ideally defined broadly, provided that the set of measures remains comprehensible, (2) concerns that P4P encourages "selection" and "teaching to the test" should not be dismissed, (3) sophisticated risk adjustment is important, especially in outcome and resource use measures, (4) involving providers in program design is vital, (5) on balance, group incentives are preferred over individual incentives, (6) whether to use rewards or penalties is context-dependent, (7) payouts should be frequent and low-powered, (8) absolute targets are generally preferred over relative targets, (9) multiple targets are preferred over single targets, and (10) P4P should be a permanent component of provider compensation and is ideally "decoupled" form base payments. However, the design of P4P programs should be tailored to the specific setting of implementation, and empirical research is needed to confirm the conclusions.

UI MeSH Term Description Entries
D009042 Motivation Those factors which cause an organism to behave or act in either a goal-seeking or satisfying manner. They may be influenced by physiological drives or by external stimuli. Incentives,Disincentives,Expectations,Disincentive,Expectation,Incentive,Motivations
D011785 Quality Assurance, Health Care Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps. Quality Assessment, Health Care,Health Care Quality Assessment,Health Care Quality Assurance,Healthcare Quality Assessment,Healthcare Quality Assurance,Quality Assessment, Healthcare,Quality Assurance, Healthcare,Assessment, Healthcare Quality,Assessments, Healthcare Quality,Assurance, Healthcare Quality,Assurances, Healthcare Quality,Healthcare Quality Assessments,Healthcare Quality Assurances,Quality Assessments, Healthcare,Quality Assurances, Healthcare
D012052 Reimbursement, Incentive A scheme which provides reimbursement for the health services rendered, generally by an institution, and which provides added financial rewards if certain conditions are met. Such a scheme is intended to promote and reward increased efficiency and cost containment, with better care, or at least without adverse effect on the quality of the care rendered. Incentive Reimbursement,Pay for Performance,Incentive Reimbursements,Performance, Pay for
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D016730 Program Development The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development). Program Descriptions,Description, Program,Descriptions, Program,Development, Program,Program Description
D017598 Efficiency, Organizational The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, material, etc. Efficiency, Administrative,Productivity, Organizational,Program Efficiency,Administrative Efficiency,Organizational Productivity,Efficiency, Program,Organizational Efficiency,Program Efficiencies
D020379 Risk Adjustment The use of severity-of-illness measures, such as age, to estimate the risk (measurable or predictable chance of loss, injury or death) to which a patient is subject before receiving some health care intervention. This adjustment allows comparison of performance and quality across organizations, practitioners, and communities. (from JCAHO, Lexikon, 1994) Case-Mix Adjustment,Adjustment, Case-Mix,Adjustment, Risk,Adjustments, Case-Mix,Adjustments, Risk,Case Mix Adjustment,Case-Mix Adjustments,Risk Adjustments

Related Publications

Frank Eijkenaar
January 2007, Journal of healthcare management / American College of Healthcare Executives,
Frank Eijkenaar
January 2005, American journal of medical quality : the official journal of the American College of Medical Quality,
Frank Eijkenaar
February 2006, The American journal of managed care,
Frank Eijkenaar
May 2006, Hospitals & health networks,
Frank Eijkenaar
January 2004, Healthcare executive,
Frank Eijkenaar
April 2014, MGMA connexion,
Frank Eijkenaar
March 2006, Journal of oncology practice,
Frank Eijkenaar
October 2006, The New England journal of medicine,
Frank Eijkenaar
October 2006, The New England journal of medicine,
Copied contents to your clipboard!