OBJECTIVE: Payment for performance fi nancial incentive schemes reward doctors based on the quality and the outcomes of their treatment. In Brazil, the Ministry of Health is looking to scale up its use in public hospitals and some municipalities are developing payment for performance schemes even for the Family Health Programme. In this article the Quality and Outcomes Framework used in the UK ...

This discussion paper reflects on the pay-for-performance system in UK general practice - the Quality and Outcomes Framework (QOF) - from an international viewpoint. The QOF intends to bring the best scientific evidence to bear on primary care practice. However, the QOF and patient-centred medicine are often at odds. Inadequacies and commercial bias in the creation of evidence make the scientif...

Healthcare reimbursements in the US have been traditionally based upon a fee-for-service (FFS) scheme, providing incentives for high volume of care, rather than efficient care. The new healthcare legislation tests new payment models that remove such incentives, such as the bundled payment (BP) system. We consider a population of patients (beneficiaries). The provider may reject patients based o...

Many health care providers and policy makers believe that health care financing systems fail to reward high-quality care. In recent years, federal and private payers have begun to promote pay for performance, or value-based purchasing, initiatives to raise the quality of care. This report describes conceptual issues in the design and implementation of pay for performance for chronic kidney dise...

In recent years there has been strong interest in episode-of-care (EOC) payment for physicians and hospitals as a replacement for fragmented, fee-for-service reimbursement. Medicare’s DRG method for hospitals can be interpreted as the nation’s first bundled payment, though it covers neither physician services nor post-acute services administered after discharge. Medicare’s Acute Care Episode (A...

BACKGROUND General practices in the UK contract with the government to receive additional payments for high-quality primary care. Little is known about the resulting impact on population health. AIM To estimate the potential reduction in population mortality from implementation of the pay-for-performance contract in England. DESIGN OF STUDY Cross-sectional and modelling study. SETTING Pri...

background and objectives: informal payment in the health settings is a significant challenge facing the health system, with consequences such as inequity in access to healthcare services, distrust to health care system, and dissatisfied customers. detailed identification of the nature of the problem is perquisite to developing relevant overcoming strategies. given that, this study aimed at pro...