Effects of pay for performance in health care: A systematic review of systematic reviews

Health Policy

Volumn 110, Issue 2-3, 2013, Pages 115-130

  Eijkenaar, Frank ^a   Emmert, Martin ^b   Scheppach, Manfred ^b   Schöffski, Oliver ^b  

^a ERASMUS UNIVERSITY ROTTERDAM   (Netherlands)

^b UNIVERSITY OF ERLANGEN NUREMBERG   (Germany)

Author keywords

Cost effectiveness; Effectiveness; Effects; Pay for performance; Systematic review; Unintended consequences

Indexed keywords

CANCER SCREENING; COST EFFECTIVENESS ANALYSIS; ECONOMIC EVALUATION; GENERAL PRACTITIONER; HEALTH CARE COST; HEALTH CARE DISPARITY; HEALTH CARE PERSONNEL; HEALTH CARE QUALITY; HOLISTIC CARE; HOSPITAL ADMISSION; HUMAN; IMMUNIZATION; MEDICAL DOCUMENTATION; MORTALITY; MOTIVATION; NURSING HOME; PATIENT CARE; PATIENT SATISFACTION; PERFORMANCE; PREVENTIVE HEALTH SERVICE; PRIMARY MEDICAL CARE; QUALITY ADJUSTED LIFE YEAR; REVIEW; RISK ASSESSMENT; SOCIOECONOMICS; SYSTEMATIC REVIEW; TOTAL QUALITY MANAGEMENT;

COST-BENEFIT ANALYSIS; HUMANS; QUALITY OF HEALTH CARE; REIMBURSEMENT, INCENTIVE; REVIEW LITERATURE AS TOPIC;

EID: 84876134201     PISSN: 01688510     EISSN: 18726054     Source Type: Journal    
DOI: 10.1016/j.healthpol.2013.01.008     Document Type: Review

References (60)

1. McGlynn E.A., Asch S.M., Adams J., Keesey J., Hicks J., DeCristofaro A., et al. The quality of health care delivered to adults in the United States. New England Journal of Medicine 2003, 348(26):2635-2645.
2. Grol R. Successes and failures in the implementation of evidence-based guidelines for clinical practice. Medical Care 2001, 39(8 Suppl. 2):II46-II54.
3. Steel N., Maisey S., Clark A., Fleetcroft R., Howe A. Quality of clinical primary care and targeted incentive payments: observational study. British Journal of General Practice 2007, 57(539):449-454.
4. Eijkenaar F. Pay for performance in health care: an international overview of initiatives. Medical Care Research and Review 2012, 69(3):251-276.
5. Rosenthal M.B. P4P: rumors of its demise may be exaggerated. American Journal of Managed Care 2007, 13(5):238-239.
6. Emmert M., Eijkenaar F., Kemter H., Esslinger A.S., Schöffski O. Economic evaluation of pay-for-performance in health care: a systematic review. The European Journal of Health Economics 2012, 13(6):755-767.
7. Eijkenaar F. Key issues in the design of pay for performance programs. The European Journal of Health Economics 2013, 14(1):117-131.
8. Dranove D., Kessler D., McClellan M., Satterthwaite M. Is more information better? The effects of " report cards on health care providers. Journal of Political Economy 2003, 111(3):555-588.
9. Doran T., Fullwood C., Reeves D., Gravelle H., Roland M. Exclusion of patients from pay-for-performance targets by English physicians. The New England Journal of Medicine 2008, 359:274-284.
10. Holmstrom B., Milgrom P. Multitask principal-agent analyses: incentive contracts, asset ownership, and job design. Journal of Law, Economics, & Organization 1991, 7:24-52.
11. Christianson J.B., Leatherman S., Sutherland K. Lessons from evaluations of purchaser pay-for-performance programs: a review of the evidence. Medical Care Research and Review 2008, 65(6):5S-35S.
12. Chien A.T., Chin M.H., Davis A.M., Casalino L.P. Pay for performance, public reporting, and racial disparities in health care: how are programs being designed?. Medical Care Research and Review 2007, 64(Suppl. 5):283S.
13. Alshamsan R., Majeed A., Ashworth M., Car J., Millett C. Impact of pay for performance on inequalities in health care: systematic review. Journal of Health Services Research & Policy 2010, 15(3):178-184.
14. Casalino L.P., Elster A., Eisenberg A., Lewis E., Montgomery J., Ramos D. Will pay-for-performance and quality reporting affect health care disparities?. Health Affairs 2007, 26(3):w405-w414.
15. Blustein J., Weissman J.S., Ryan A.M., Doran T., Hasnain-Wynia R. Analysis raises questions on whether pay-for-performance in Medicaid can efficiently reduce racial and ethnic disparities. Health Affairs 2011, 30(6):1165-1175.
16. Mehrotra A., Sorbero M.E.S., Damberg C.L. Using the lessons of behavioral economics to design more effective pay-for-performance programs. American Journal of Managed Care 2010, 16(7):497-503.
17. Conrad D.A., Perry L. Quality-based financial incentives in health care: can we improve quality by paying for it?. Annual Review of Public Health 2009, 30:357-371.
18. Cochrane handbook for systematic reviews of interventions 2008, West Sussex, England, John Wiley & Sons, Ltd. J. Higgins, S. Green (Eds.).
19. Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen Allgemeine Methoden, Version 3 2009, Available from:, [24.11.09]. http://www.iqwig.de/download/IQWiG_Methoden_Version_3_0.pdf.
20. Graf von der Schulenburg J.M., Greiner W., Jost F., Klusen N., Kubin M., Leidl R., et al. Deutsche Empfehlungen zur gesundheitsökonomischen Evaluation - dritte und aktualisierte Fassung des Hannoveraner Konsens. Gesundheitsökonomie und Qualitätsmanagement 2007, 12(5):285-290.
21. Craig D., Rice S. NHS economic evaluation database handbook 2009, Available from:, [11.08.09]. http://www.york.ac.uk/inst/crd/pdf/nhseed-handb07.pdf.
22. Dreier M, Borutta B, Stahmeyer J, Krauth C, Walter U. Vergleich von Bewertungsinstrumenten für die Studienqualität von Primär- und Sekundärstudien zur Verwendung für HTA-Berichte im deutschsprachigen Raum, 1st ed. Cologne; 2010.
23. Dudley R, Frolich A, Robinowitz D, Talavera J, Broadhead P, Luft H. Strategies to support quality-based purchasing: a review of the evidence. Technical Review 10. AHRQ publication No. 04-0057. Rockville, MD: Agency for Healthcare Research and Quality; July 2004.
24. Town R., Kane R., Johnson P., Butler M. Economic incentives and physicians' delivery of preventive care - a systematic review. American Journal of Preventive Medicine 2005, 28(2):234-240.
25. Rosenthal M.B., Frank R.G. What is the empirical basis for paying for quality in health care?. Medical Care Research and Review 2006, 63(2):135-157.
26. Schatz M. Does pay-for-performance influence the quality of care?. Current Opinion in Allergy and Clinical Immunology 2008, 8(3):213-221.
27. Briesacher B., Field T., Baril J., Gurwitz J. Pay-for-performance in nursing homes. Health Care Financing Review 2009, 30(3):1-13.
28. Sorbero MES, Damberg CL, Shaw R, Teleki S, Lovejoy SL, DeChristofaro AH, et al. Assessment of pay-for-performance options for medicare physician services: final report. RAND Health, Working Paper WR-391-ASPE; 2006.
29. van Herck P., Smedt D.de, Annemans L., Remmen R., Rosenthal M.B., Sermeus W. Systematic review: effects, design choices, and context of pay-for-performance in health care. BMC Health Services Research 2010, 10:247.
30. Sabatino S., Habarta N., Baron R., Coates R., Rimer B., Kerner J., et al. Interventions to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers systematic reviews of provider assessment and feedback and provider incentives. American Journal of Preventive Medicine 2008, 35(Suppl. 1):S67-S74.
31. Steel N., Willems S. Research learning from the UK quality and outcomes framework: a review of existing research. Quality in Primary Care 2010, 18(2):117-125.
32. Mehrotra A., Damberg C., Sorbero M., Teleki S. Pay for performance in the hospital setting: what is the state of the evidence?. American Journal of Medical Quality 2009, 24(1):19-28.
33. Petersen L., Woodard L., Urech T., Daw C., Sookanan S. Does pay-for-performance improve the quality of health care?. Annals of Internal Medicine 2006, 145(4):265-272.
34. Kane R.L., Johnson P.E., Town R.J., Butler M. Economic incentives for preventive care. Evidence Report/Technology Assessment (Summary) 2004, (101):1-7.
35. Scott A., Sivey P., Ait Ouakrim D., Willenberg L., Naccarella L., Furler J., et al. The effect of financial incentives on the quality of health care provided by primary care physicians. Cochrane Database of Systematic Reviews 2011, 9:CD008451.
36. Armour B.S., Pitts M.M. Physician financial incentives in managed care: resource use, quality and cost implications. Disease Management and Health Outcomes 2003, 11(3):139-147.
37. Chaix-Couturier C., Durand-Zaleski I., Jolly D., Durieux P. Effects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues. International Journal for Quality in Health Care 2000, 12(2):133-142.
38. Walker S., Mason A., Claxton K., Cookson R., Fenwick E., Fleetcroft R., et al. Value for money and the quality and outcomes framework in primary care in the UK NHS. British Journal of General Practice 2010, 60(574):e213-e220.
39. Cheng S., Lee T., Chen C. A longitudinal examination of a pay-for-performance program for diabetes care: evidence from a natural experiment. Medical Care 2012, 50(2):109-116.
40. McDonald R., Roland M. Pay for performance in primary care in England and California: comparison of unintended consequences. Annals of Family Medicine 2009, 7(2):121-127.
41. Wang H., Zhang L., Yip W., Hsiao W. An experiment in payment reform for doctors in rural China reduced some unnecessary care but did not lower total costs. Health Affairs 2011, 30(12):2427-2436.
42. Chen T., Chung K., Lin I., Lai M. The unintended consequence of diabetes mellitus pay-for-performance (P4P) program in Taiwan: are patients with more comorbidities or more severe conditions likely to be excluded from the P4P program?. Health Services Research 2011, 46(1 Pt 1):47-60.
43. Chang R., Lin S., Aron D.C. A pay-for-performance program in Taiwan improved care for some diabetes patients, but doctors may have excluded sicker ones. Health Affairs 2012, 31(1):93-102.
44. Campbell S.M., Kontopantelis E., Reeves D., Valderas J.M., Gaehl E., Small N., et al. Changes in patient experiences of primary care during health service reforms in England between 2003 and 2007. Annals of Family Medicine 2010, 8(6):499-506.
45. Doran T., Kontopantelis E., Valderas J.M., Campbell S., Roland M., Salisbury C., et al. Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework. BMJ 2011, 342:d3590.
46. Gravelle H., Sutton M., Ma A. Doctor behaviour under a pay for performance contract: treating, cheating and case finding?. The Economic Journal: The Journal of the Royal Economic Society 2010, 120(542):F129-F156.
47. Doran T., Fullwood C., Kontopantelis E., Reeves D. Effect of financial incentives on inequalities in the delivery of primary clinical care in England: analysis of clinical activity indicators for the quality and outcomes framework. Lancet 2008, 372(9640):728-736.
48. Lee J.T., Netuveli G., Majeed A., Millett C. The effects of pay for performance on disparities in stroke, hypertension, and coronary heart disease management: interrupted time series study. PLoS ONE 2011, 6(12):e27236.
49. Fung C.H., Lim Y.W., Mattke S., Damberg C., Shekelle P.G. Systematic review: the evidence that publishing patient care performance data improves quality of care. Annals of Internal Medicine 2008, 148(2):111-123.
50. Jha A.K., Joynt K.E., Orav E.J., Epstein A.M. The long-term effect of premier pay for performance on patient outcomes. New England Journal of Medicine 2012, 366(17):1606-1615.
51. Mullen K.J., Frank R.G., Rosenthal M.B. Can you get what you pay for? Pay-for-performance and the quality of healthcare providers. Rand Journal of Economics 2010, 41(1):64-91.
52. Department of Health and Human Services Hospital inpatient value-based purchasing program. Final rule. Federal Register 2011, 88(88):26490-26547.
53. NHS North West Advancing quality 2012, http://www.advancingqualitynw.nhs.uk/index.php.
54. Balicer R.D., Shadmi E., Lieberman N., Greenberg-Dotan S., Goldfracht M., Jana L., et al. Reducing health disparities: strategy planning and implementation in Israel's largest health care organization. Health Services Research 2011, 46(4):1281-1299.
55. Ryan A.M., Blustein J., Doran T., Michelow M.D., Casalino L.P. The effect of phase 2 of the premier hospital quality incentive demonstration on incentive payments to hospitals caring for disadvantaged patients. Health Services Research 2012, 47(4):1418-1436.
56. Christianson J.B., Leatherman S., Sutherland K. Financial incentives, healthcare providers and quality improvements: a review of the evidence 2007, The Health Foundation, London.
57. Eldridge C., Palmer N. Performance-based payment: some reflections on the discourse, evidence and unanswered questions. Health Policy and Planning 2009, 24(3):160-166.
58. Frølich A., Talavera J.A., Broadhead P., Dudley R.A. A behavioral model of clinician responses to incentives to improve quality. Health Policy 2007, 80(1):179-193.
59. Giuffrida A., Gosden T., Forland F., Kristiansen I.S., Sergison M., Leese B., et al. Target payments in primary care: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2000, 4:CD000531.
60. Flodgren G., Eccles M.P., Shepperd S., Scott A., Parmelli E., Beyer F.R. An overview of reviews evaluation the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes. Cochrane Database of Systematic Reviews 2011, 7:CD009255.