Can We Expect Results-Based Financing to Improve Quality of Care?

Results-based financing (RBF) schemes in health care are premised on the notion that “paying for results” rather than for inputs is more likely to improve performance. But getting from that attractive hypothesis to program efforts that improve quality of care and outcomes at population scale—in the real world—is far from simple. The article by Gergen in this issue of GHSP offers an overview of a set of RBF schemes, mainly funded under the World Bank’s Health Results Innovation Trust Fund (HRITF). Under this funding, performance-based incentives are paid to health workers and health facilities, with the intention of improving quality of health services for women and children. As of late 2016, this major funding program, supported primarily by the governments of Norway and the United Kingdom, has provided close to US$400 million in grants and more than US$2 billion in associated loans to RBF programs in 29 countries.