Pay for performance (P4P) is becoming increasingly popular in the health care sector as a tool for encouraging performance (especially quality) improvement. Evidence about the effect of policies in hospitals is rare and generally confined to developed countries. The Iranian hospital grading system, which links the charges hospitals can make for patient stay to the results of their annual perfor...

Managers and policymakers are seeking practical guidelines for assessing the outcomes of emerging pay-for-performance (P4P) programs. Evaluations of P4P programs published to date are mixed-some are confusing-and methodological problems with them are common. This article first identifies and summarizes obstacles to implementing effective P4P programs. Second, it describes results from social sc...

This paper reports on a two-tiered experiment designed to separately identify the selection and effort margins of pay for performance (P4P). At recruitment stage, teacher labor markets were randomly assigned “pay-for-percentile” or fixed-wage contract. Once recruits placed, an unexpected, incentive-compatible, school-level re-randomization was performed so that some teachers who applied contrac...

Pay for performance (or P4P) may seem like a distant phenomenon to many physicians – one they don’t want to concern themselves with just yet. However, in the past few years, P4P programs have proliferated. Virtually all major payers, including Medicare, are piloting P4P programs and will soon be measuring physician performance and offering financial incentives to those who meet quality target...

Medicare has sought to improve patient care through pay-for-performance (P4P) programs that better align hospitals’ financial incentives with quality of service. However, the design of these policies is subject to a variety of practical and institutional constraints, such as the use of “small” performance-based incentives. We develop a framework based on a stylized principal-agent model to char...

Pay-for-performance (P4P) has become one of the dominant approaches to improving quality of care, yet few studies have evaluated its effectiveness. We evaluated the impact on quality of all P4P programs introduced into physician group contracts during 2001-2003 by the five major commercial health plans operating in Massachusetts. Overall, P4P contracts were not associated with greater improveme...

Studies have shown that the lowest performing physicians in pay-for-performance (P4P) programs improved the most; however, it is unclear whether this would occur without the P4P program or be sustained. The objective of this study is to investigate the impact of P4P in a Preferred Provider Organization (PPO) on low performing physicians over a 4-year period. We used administrative claims data f...

BACKGROUND The impact of pay-for-performance (P4P) programs on long-term mortality for chronic illnesses, especially diabetes mellitus, has been rarely reported. Several studies described the favorable impact of P4P for diabetes mellitus on medical utilizations or intermediate outcomes. Therefore, this study aimed to investigate the impact of a P4P program on mortality in patients with type 2 d...

The concept of "pay for performance" (P4P) applied to the practice of medicine has become a major foundation in current public and private payer reimbursement strategies for both institutional and individual physician providers. "Pay for performance" programs represent a substantial shift from traditional service-based reimbursement to a system of performance-based provider payment using financ...