Physician pay-for-performance. Implementation and research issues.
Recent research underscores the gaps that exist between evidence-based medical practices and the care that many patients actually receive. Recognizing this, large purchasers are experimenting with new reimbursement arrangements called pay-for-performance (P4P) that tie a portion of payments for physician services to measures of quality. Agency theory, from the discipline of economics, provides a perspective on the challenges P4P is likely to encounter. The focus of most P4P initiatives on medical group performance raises additional questions about its potential effectiveness as a catalyst for change.
Christianson
Jon B
JB
Division of Health Services Research and Policy, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA. chris001@umn.edu
Knutson
David J
DJ
Mazze
Roger S
RS
D004650:Employee Performance Appraisal; D019317:Evidence-Based Medicine / Q000592:standards; D006123:Group Practice / Q000191:economics / Q000592:standards; D006302:Health Services Research; D006801:Humans; D010816:Physician Incentive Plans / Q000191:economics*; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards; D011785:Quality Assurance, Health Care / Q000191:economics*; D012052:Reimbursement, Incentive