Implementation Processes and Pay for Performance in Healthcare: A Systematic Review

Journal of General Internal Medicine

Volumn 31, Issue , 2016, Pages 61-69

  Kondo, Karli K ^a,c   Damberg, Cheryl L ^b   Mendelson, Aaron ^c   Motu’apuaka, Makalapua ^a   Freeman, Michele ^a   O’Neil, Maya ^a,c   Relevo, Rose ^a   Low, Allison ^a   Kansagara, Devan ^a,c  

^a PORTLAND VA MEDICAL CENTER   (United States)

^b RAND CORPORATION   (United States)

^c OREGON HEALTH AND SCIENCE UNIVERSITY   (United States)

Author keywords

financial incentives; implementation; pay for performance; performance metrics; systematic review

Indexed keywords

CINAHL; HUMAN; INTERVIEW; MEDLINE; MODEL; NURSING HOME; OBSERVATIONAL STUDY; PSYCINFO; SCIENTIST; SYSTEMATIC REVIEW; CLINICAL TRIAL (TOPIC); ECONOMICS; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HOSPITAL; OUTPATIENT DEPARTMENT; PROCEDURES; PROGRAM EVALUATION; REIMBURSEMENT; STANDARDS;

AMBULATORY CARE FACILITIES; CLINICAL TRIALS AS TOPIC; DELIVERY OF HEALTH CARE; HOSPITALS; HUMANS; NURSING HOMES; OBSERVATIONAL STUDIES AS TOPIC; PROGRAM EVALUATION; QUALITY OF HEALTH CARE; REIMBURSEMENT, INCENTIVE;

EID: 84960091603     PISSN: 08848734     EISSN: 15251497     Source Type: Journal    
DOI: 10.1007/s11606-015-3567-0     Document Type: Article

References (50)

1. Department of Veterans Affairs. Department of Veterans Affairs Health Care Personnel Enhancement Act of 20042004.
2. United States Government Accountability Office. VA Health Care. Actions needed to improve administration of the provider performance pay and award systems: Report to congressional requesters. 2013.
3. Kizer KW, Kirsh SR. The double edged sword of performance measurement. J Gen Intern Med. 2012;27(4):395–7.
4. Petersen LA, Woodard LD, Urech T, Daw C, Sookanan S. Does pay-for-performance improve the quality of health care? Ann Intern Med. 2006;145(4):265–72.
5. Damberg C, Sorbero M, Lovejoy S, Martsolf G, Raaen L, Mandel D. Measuring Success in Health Care: Value-Based Purchasing Programs. Findings from an Environmental Scan, Literature Review, and Expert Panel Discussions. Santa Monica, California. 2014.
6. Treadwell JR, Singh S, Talati R, McPheeters ML, Reston JT. A Framework for “Best Evidence” Approaches in Systematic Reviews. 2011.
7. Wells G, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed Nov 19, 2015.
8. Damschroder L, Aron D, Keith R, Kirsh S, Alexander J, Lowery J. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci: IS. 2009;4(50).
9. Kantarevic J, Kralj B. Link between pay for performance incentives and physician payment mechanisms: evidence from the diabetes management incentive in Ontario. Health Econ. 2013;22(12):1417–39.
10. de Brantes FS, D’Andrea BG. Physicians respond to pay-for-performance incentives: larger incentives yield greater participation. Am J Manag Care. 2009;15(5):305–10.
11. Rodriguez HP, von Glahn T, Elliott MN, Rogers WH, Safran DG. The effect of performance-based financial incentives on improving patient care experiences: a statewide evaluation. J Gen Intern Med. 2009;24(12):1281–8.
12. Young GJ, Beckman H, Baker E. Financial incentives, professional values and performance: a study of pay-for-performance in a professional organization. J Organ Behav. 2012;33(7):964–83.
13. Waddimba AC, Meterko M, Beckman HB, Young GJ, Burgess JF Jr. Provider attitudes associated with adherence to evidence-based clinical guidelines in a managed care setting. Med Care Res Rev. 2010;67(1):93–116.
14. Baek JD, Xirasagar S, Stoskopf CH, Seidman RL. Physician-targeted financial incentives and primary care physicians’ self-reported ability to provide high-quality primary care. J Prim Care Community Health. 2013;4(3):182–8.
15. Helm C, Holladay CL, Tortorella FR. The performance management system: applying and evaluating a pay-for-performance initiative… including commentary by Candio C. J Healthc Manag. 2007;52(1):49–63.
16. Hadley J, Landon BE, Reschovsky JD. Effects of compensation methods and physician group structure on physicians’ perceived incentives to alter services to patients. Health Serv Res. 412006:1200+.
17. Hearld LR, Alexander JA, Shi Y, Casalino LP. Pay-for-performance and public reporting program participation and administrative challenges among small- and medium-sized physician practices. Med Care Res Rev: MCRR. 2014;71(3):299–312.
18. Walker S, Mason AR, Claxton K, et al. Value for money and the quality and outcomes framework in primary care in the UK NHS. Br J Gen Pract: J R Coll Gen Pract. 2010;60(574):e213–20.
19. Chen T-T, Lai M-S, Lin IC, Chung K-P. Exploring and comparing the characteristics of nonlatent and latent composite scores: implications for pay-for-performance incentive design. Med Decis Mak. 2012;32(1):132–44.
20. Werner RM, Dudley RA. Making the ‘pay’matter in pay-for-performance: implications for payment strategies. Health Aff. 2009;28(5):1498–508.
21. Andriole KP, Prevedello LM, Dufault A, et al. Augmenting the impact of technology adoption with financial incentive to improve radiology report signature times. J Am Coll Radiol. 2010;7(3):198–204.
22. Benzer JK, Young GJ, Burgess JF Jr, et al. Sustainability of quality improvement following removal of pay-for-performance incentives. J Gen Intern Med. 2013;29(1):127–32.
23. Hysong SJ, Khan MM, Petersen LA. Passive monitoring versus active assessment of clinical performance: impact on measured quality of care. Med Care. 2011;49(10):883–90.
24. Shih T, Nicholas LH, Thumma JR, Birkmeyer JD, Dimick JB. Does pay-for-performance improve surgical outcomes? An evaluation of phase 2 of the premier hospital quality incentive demonstration. Ann Surg. 2014;259(4):677–81.
25. Feng Y, Ma A, Farrar S, Sutton M. The tougher the better: an economic analysis of increased payment thresholds on performance of general practices. Health Econ. 2014.
26. Kontopantelis E, Doran T, Gravelle H, Goudie R, Siciliani L, Sutton M. Family doctor responses to changes in incentives for influenza immunization under the UK quality and outcomes framework pay-for-performance scheme. Health Serv Res. 2012;47(3 Pt 1):1117–36.
27. Kontopantelis E, Springate D, Reeves D, Ashcroft DM, Valderas JM, Doran T. Withdrawing performance indicators: retrospective analysis of general practice performance under UK quality and outcomes framework. BMJ (Clin Res ed). 2014;348:g330.
28. Caley M, Burn S, Marshall T, Rouse A. Increasing the QOF upper payment threshold in general practices in England: impact of implementing government proposals. Br J Gen Pract: J R Coll Gen Pract. 2014;64(618):e54–9.
29. Arrowsmith ME, Majeed A, Lee JT, Saxena S. Impact of pay for performance on prescribing of long-acting reversible contraception in primary care: an interrupted time series study. PLoS One. 2014;9(4):e92205.
30. Bhattacharyya T, Mehta P, Freiberg AA. Hospital characteristics associated with success in a pay-for-performance program in orthopaedic surgery. J Bone Joint Surg Am Vol. 2008;90A(6):1240–3.
31. Greene J. An examination of pay-for-performance in general practice in Australia. Health Serv Res. 2013;48(4):1415–32.
32. Kirschner K, Braspenning J, Jacobs JE, Grol R. Experiences of general practices with a participatory pay-for-performance program: a qualitative study in primary care. Aust J Prim Health. 2013;19(2):102–6.
33. Ashworth M, Armstrong D. The relationship between general practice characteristics and quality of care: a national survey of quality indicators used in the UK quality and outcomes framework, 2004–5. BMC Fam Pract. 2006;7:68.
34. Ashworth M, Schofield P, Seed P, Durbaba S, Kordowicz M, Jones R. Identifying poorly performing general practices in England: a longitudinal study using data from the quality and outcomes framework. J Health Serv Res Policy. 2011;16(1):21–7.
35. Walker N, Bankart J, Brunskill N, Baker R. Which factors are associated with higher rates of chronic kidney disease recording in primary care? A cross-sectional survey of GP practices. Br J Gen Pract: J R Coll Gen Pract. 2011;61(584):203–5.
36. Wang Y, O’Donnell CA, Mackay DF, Watt GC. Practice size and quality attainment under the new GMS contract: a cross-sectional analysis. Br J Gen Pract: J R Coll Gen Pract. 2006;56(532):830–5.
37. Doran T, Campbell S, Fullwood C, Kontopantelis E, Roland M. Performance of small general practices under the UK’s quality and outcomes framework. Br J Gen Pract. 2010;60(578):335–44.
38. Morgan CL, Beerstecher HJ. Primary care funding, contract status, and outcomes: an observational study. Br J Gen Pract: J R Coll Gen Pract. 2006;56(532):825–9.
39. Tahrani AA, McCarthy M, Godson J, et al. Impact of practice size on delivery of diabetes care before and after the quality and outcomes framework implementation. Br J Gen Pract: J R Coll Gen Pract. 2008;58(553):576–9.
40. Gemmell I, Campbell S, Hann M, Sibbald B. Assessing workload in general practice in England before and after the introduction of the pay-for-performance contract. J Adv Nurs. 2009;65(3):509–15.
41. Dalton ARH, Alshamsan R, Majeed A, Millett C. Exclusion of patients from quality measurement of diabetes care in the UK pay-for-performance programme. Diabet Med. 2011;28(5):525–31.
42. Kruse GR, Chang Y, Kelley JH, Linder JA, Einbinder JS, Rigotti NA. Healthcare system effects of pay-for-performance for smoking status documentation. Am J Manage Care. 2013;19(7):554–61.
43. Li J, Hurley J, Decicca P, Buckley G. Physician response to pay-for-performance: evidence from a natural experiment. Health Econ. 2013.
44. Norbury M, Fawkes N, Guthrie B. Impact of the GP contract on inequalities associated with influenza immunisation: a retrospective population-database analysis. Br J Gen Pract: J R Coll Gen Pract. 2011;61(588):e379–85.
45. Vamos EP, Pape UJ, Bottle A, et al. Association of practice size and pay-for-performance incentives with the quality of diabetes management in primary care. CMAJ: Can Med Assoc J. 2011;183(12):E809–16.
46. Miller SC, Looze J, Shield R, et al. Culture change practice in u.s. Nursing homes: prevalence and variation by state medicaid reimbursement policies. The Gerontologist. 2014;54(3):434–45.
47. Begum R, Smith Ryan M, Winther CH, et al. Small practices’ experience with EHR, quality measurement, and incentives. Am J Manage Care. 2013;19(10 Spec No):eSP12–8.
48. Kirschner K, Braspenning J, Akkermans RP, Jacobs JE, Grol R. Assessment of a pay-for-performance program in primary care designed by target users. Fam Pract. 2013;30(2):161–71.
49. Saint-Lary O, Bernard E, Sicsic J, Plu I, Francois-Purssell I, Franc C. Why did most French GPs choose not to join the voluntary national pay-for-performance program? PLoS One. 2013;8(9):e72684.
50. Torchiana DF, Colton DG, Rao SK, Lenz SK, Meyer GS, Ferris TG. Massachusetts general physicians organization’s quality incentive program produces encouraging results. Health Aff. 2013;32(10):1748–56.