Pay-for-performance in health care: What can we learn from international experience

Quality Management in Health Care

Volumn 22, Issue 1, 2013, Pages 2-15

  Wilson, Kimberly J ^a  

^a UNIVERSITY OF TEXAS AT AUSTIN   (United States)

Author keywords

Financial incentives; Health care; Pay for performance; Quality care; Quality indicators; Quality of health care

Indexed keywords

ARTICLE; AUSTRALIA; CANADA; ECONOMICS; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HUMAN; ITALY; MOTIVATION; REIMBURSEMENT; SPAIN; UNITED KINGDOM; UNITED STATES;

AUSTRALIA; CANADA; DELIVERY OF HEALTH CARE; GREAT BRITAIN; HUMANS; ITALY; MOTIVATION; QUALITY OF HEALTH CARE; REIMBURSEMENT, INCENTIVE; SPAIN; UNITED STATES;

EID: 84872078394     PISSN: 10638628     EISSN: 15505154     Source Type: Journal    
DOI: 10.1097/QMH.0b013e31827dea50     Document Type: Article

References (57)

1. Mannion R, Davies H. Payment for performance in health care. BMJ. 2008;336:306-308. (Pubitemid 351271260)
2. Christianson JB, Leatherman S, Sutherland K. Lessons from evaluations of purchaser pay-for-performance programs:a review of the evidence. Med Care Res Rev. 2008;65(6 suppl):5S-35S.
3. Petersen LA,Woodard DL, Urech T, Daw C, Sookanan S. Does pay-for-performance improve the quality of health care? Ann Intern Med. 2006;145(4):265-272. (Pubitemid 46768610)
4. RosenthalMB, Dudley AR. Pay-for-performance:will the latest payment trend improve care? JAMA. 2007;297:740-744. (Pubitemid 46294563)
5. RosenthalMB, Fernandopulle R, Ryu Song HS, Landon B. Paying for quality:providers' incentives for quality improvement. Health Aff. 2004;23(2):127-141. (Pubitemid 38471049)
6. Rosenthal MB, Landon BE, Howitt K, Ryu Song HS, Epstein AM. Climbing up the pay-for-performance learning curve:where are the early adopters now? Health Aff. 2007;26(6):1674-1682.
7. Van Herck P, De Smedt D, Annemans L, Remmen R, Rosenthall MB, Sermeus W. Systematic review:effects, design choices, and context of pay-for-performance in health care. BMC Health Serv Res. 2010;10:247-259.
8. Boxall A-M. Shouldwe expand the use of pay-for-performance in health care? Parliament of Australia Department of Parliamentary Services, 2009. Research Paper no. 12.
9. Medicare Australia Web site. http://www.medicare australia.gov.au/ provider/incentives/pip/index.jsp. Accessed April 12, 2012.
10. Davies G. Queensland Public Hospitals Commission of Inquiry:final report. http://www.qphci.qld.gov.au/. Accessed April 10, 2012.
11. Van Der Weyden MB. The Bundaberg Hospital scandal:the need for reform in Queensland and beyond. Med J Aust. 2005;183(6):284-285. (Pubitemid 41341670)
12. Duckett S, Daniels S, Kamp M, Stockwell A, Walker G, Ward M. Pay for performance in Australia:Queensland's new Clinical Practice Improvement Payment. J Health Serv Res Policy. 2008;13(3):174-177. (Pubitemid 352029760)
13. Glazier RH, Klein-Geltink J, Kopp A, Sibley LM. Capitation and enhanced fee-for-service models for primary care reform:a population-based evaluation. Can Med Assoc J. 2009;180(11):E72-E81.
14. Tawfik-Shukor AR, Klazinga NS, Arah OA. Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada. BMC Health Serv Res. 2007;7:25. doi:10.1186/1472-6963-7-25. (Pubitemid 46364974)
15. Canadian Institute for Health Information. President's Quarterly Report and Review of Financial Statements. 2009 http://www.cihi.ca/CIHI-ext-portal/pdf/ internet/FINANCIAL- REPORT-FY09-10-Q3-EN. Accessed November 26, 2012.
16. Canadian Institute for Health Information. Summary report. Funding Models to Support Quality and Sustainability:A Pan- Canadian Dialogue, 2010. Edmonton, Alberta:Canadian Institute for Health Information; 2011:4.
17. Donatini A, Romagna E, Reed SJ, Squires D. The Italian health care system. International Profiles of Health Care. Washington, DC:Commonwealth Fund; 2011:67-74.
18. Lo Scalso A, Donatini A, Orzella L, Cicchetti A, Profili S, Maresso A. Italy:health system review. Health Syst Transit. 2009;11(6):1-216.
19. Lippi Bruni M, Nobilio L, Ugolini C. Economic incentives in general practice:the impact of pay-for-participation and pay-for-compliance programs on diabetes care. Health Policy. 2009;90:140-148.
20. Brown P, Calnan M, Vainieri M, Bonini A, Nuti S. A Comparative Analysis of Quality Incentives in Healthcare Systems in England and Tuscany:'Fiduciary Reputation' Rather Than 'Standards and Sanctions.' Working paper n. 01. Series of Laboratorio Management e Sanita:Scuola Superiore Sant'Anna di Pisa; 2009.
21. Nuti S, Daraio C, Speroni C, Vainieri M. Developing a Combined Quantitative Benchmarking System for the Performance of Local Health Authorities:the Case of the Tuscany Region in Italy.Working paper n. 03:Series of Laboratorio Management e Sanita:Scuola Superiore Sant'Anna di Pisa; 2009.
22. Nuti S, Vainieri M, Bonini A. Evaluating Performance in the Tuscan Health Care System. Working paper n. 02. Series of Laboratorio Management e Sanita:Scuola Superiore Sant'Anna di Pisa; 2005.
23. Nuti S, Vainieri M, Seghieri C, Bonini A. Linking Measurement to Performance Management in Public Health Care Systems. Series of Laboratorio Management e Sanita:Scuola Superiore Sant'Anna di Pisa; 2010.
24. Pinnareli L, Nuti S, Sorge C, et al. What drives hospital performance? The impact of comparative outcome evaluation of patients admitted for hip fracture in two Italian Regions. BMJ Qual Saf. 2012;21(2):127-134.
25. Benavent J, Juan C, Clos J, Sequeira E, Gimferrer N, Vilaseca J. Pay-for-performance in primary healthcare centres in Spain. Qual Prim Care. 2009;17(2):123-131.
26. CatSalut. Compra de Serveis 2011:Contractes d'Atencio Primaria (2011 Purchasing Contract:Primary Care Services). Barcelona:Divisio d'Avaluacio de Serveis; 2009.
27. Arguasca TM, Argimon J. Country Case Study Spain:Primary care in Catalonia. Conference Report:Improving Primary Care in Europe and the U.S.:Towards Patient-Centered, Proactive and Coordinated Systems of Care. 2008.
28. Roland M. Linking physicians' pay to the quality of care - a major experiment in the United Kingdom. New Engl J Med. 2004;351:1448-1454. (Pubitemid 39288172)
29. NHS Employers. The new QOF areas and indicators. 2012. http://www.nhsemployers.org/PayAndContracts/General MedicalServicesContract/QOF/ Pages/QualityOutcomes Framework.aspx. Accessed March 25, 2012.
30. Doran T, Fullwood C, Gravelle H, et al. Pay-for-performance programs in family practices in the United Kingdom. New Engl J Med. 2006;355:375-384. (Pubitemid 44127540)
31. Institute of Medicine. Crossing the Quality Chasm:A New Health System for the 21st Century.Washington, DC:National Academy Press; 2001.
32. Lindenauer PK, Remus D, Roman S, et al. Public reporting and pay for performance in hospital quality improvement. New Engl J Med. 2007;356:486-496. (Pubitemid 46193076)
33. Gosden T, Forland F, Kristiansen IS, et al. Impact of payment method on behaviour of primary care physicians:a systematic review. J Health Serv Res Policy. 2001;6:44-55. (Pubitemid 32112532)
34. Hutchison B, Birch S, Hurley J, et al. Do physician-patient mechanisms affect hospital utilization? A study of Health Service Organizations in Ontario. CMAJ. 1996;154:653-661. (Pubitemid 26074845)
35. Schen J, Andersen R, Brook R, et al. The effects of payment method on clinical decision-making:physician responses to clinical scenarios. Med Care. 2004;42:297-302.
36. Carlson JJ, Sullivan SD, Garrison LP, Neumann PJ, Venstra DL. Linking payment to health outcomes:a taxonomy and examination of performance-based reimbursement schemes between healthcare payers and manufacturers. Health Policy. 2010;96(3):179-190.
37. Neri S. The development of health care policy and the new governance of the NHS in Italy. Paper presented at:7th ESPAnet Conference; 2009; Urbino, Italy.
38. Figueras J, Robinson R, Jakubowski E, eds. Purchasing to Improve Health Systems Performance. Geneva, Switzerland:European Observatory on Health Systems and Policies of the World Health Organization; 2005.
39. Cinquini L, Vainieri M. Measuring primary care services performance:issues and opportunities from a home care pilot experience in the Tuscan health system. Health Serv Manage Res. 2008;21(3):199-210.
40. Stockwell A. Evaluation of Financial Incentives as a Quality Improvement Strategy in the Public Health Context:Clinician Attitudes, Design Variables, and Economic Costs [Professional Doctorate thesis]. Queensland University of Technology; 2010:118-119.
41. Elovainio R. Performance Incentives for Health in High- Income Countries:Key Issues and Lessons Learned. World Health Report, Background Paper 32. Geneva, Switzerland: World Health Organization; 2010.
42. Maynard A. Payment for Performance (P4P):International Experience and a Cautionary Proposal for Estonia. Health Financing Policy Paper, Division of Country Health Systems. Geneva, Switzerland:World Health Organization; 2008.
43. Folland S, Goodman AC, Stano M. Asymmetric information and agency. The Economics of Health and Health Care. 5th ed. Princeton, NJ:Pearson Prentice Hall; 2007:207-208.
44. Gravelle H, SuttonM,Ma A. Doctor Behaviour Under a Pay for Performance Contract:Evidence From the Quality and Outcomes Framework. CHE Research Paper no. 28. York, England: Centre for Health Economics; 2007.
45. Gravelle H, Sutton M, Ma A. Doctor behaviour under a pay for performance contract:treating, cheating and case finding? Econ J. 2010;120:F129-F156.
46. Serumaga B, Ross-Degnan D, Avery AJ, et al. Effect of pay for performance on the management and outcomes of hypertension in the United Kingdom:interrupted time series study. BMJ. 2011;342:d108. doi:10.1136/bmj.d108.
47. Alshamsan R, Majeed A, Ashworth M, Car J, Millett C. Impact of pay for performance on inequalities in health care:systematic review. J Health Serv Res Policy. 2010;15(3):178-184.
48. Campbell SM, McDonald R, Lester H. The experience of pay for performance in English family practice:a qualitative study. Ann Fam Med. 2008;6(3):228-234. (Pubitemid 351716781)
49. The NHS Information Centre. Prescribing and Primary Care Services:Quality and Outcomes Framework Achievement Data 2010/11. The Health and Social Care Information Centre of the National Health Service; 2011. http://www.ic.nhs.uk/ webfiles/publications/002-Audits/QOF- 2010-11/QOF-Achievement-and-Prevalence- Bulletin-2010- 11-v1.0.pdf. Accessed November 26, 2012.
50. Hillman AL, Pauly MV, Kerman K, Martinek CR. HMO managers' views on financial incentives and quality. Health Aff. 1991;10(4):207-219.
51. John Snow, Inc. Director. Paper presented at:38th Annual Global Health Conference:Ghana Focus Region Health Project; June 2011; Washington, DC
52. Jha AK, Doolan D, Grandt D, Scott T, Bates DW. The use of health information technology in seven nations. Int J Med Inform. 2008;77(12):848-854.
53. Schoen C, Osborn R, Doty M, Squires D, Peugh J, Applebaum S. A survey of primary care physicians in eleven countries, 2009:perspectives on care, costs, and experiences. Health Aff. 2009;28(6):w1171-w1183.
54. Schoen C, Osborn R, Huynh PT, Doty M, Peugh J, Zapert K. On the front lines of care:primary care doctors' office systems, experiences, and views in seven countries. Health Aff. 2006;25(6):w555-w571. (Pubitemid 44871703)
55. NCQA Web site. What is HEDIS? http://www.ncqa. org/tabid/187/Default. aspx. Accessed April 14, 2012.
56. Scott IA. Pay for performance in health care:strategic issues for Australian experiments. Med J Aust. 2007;187(1):31-35. (Pubitemid 47082735)
57. Fleetcroft R, Cookson R. Do incentive payments in the new NHS contract for primary care reflect likely population health gain? J Health Serv Res Policy. 2006;11(1):27-31. (Pubitemid 43117110)