title: Incentive implementation in physician practices: A qualitative study of practice executive perspectives on pay for performance.
abstract: Pay-for-performance (P4P) programs offer health care providers financial incentives to achieve predefined quality targets. Practice executives sit at a key nexus point for determining how P4P programs are implemented in physician practices. Using a qualitative interview design, this article examines the role practice executives play in the implementation of P4P programs and how their perspectives and decisions can influence the success of these programs. The authors identified five key findings related to practice executives' views on P4P: quality incentives are better than utilization incentives, quality incentives are bonus rewards, quality incentives are agents for change, providers do not feel they have control over attaining quality targets, and the ways in which quality is measured are problematic. The authors discuss five different ways in which practice executives distribute rewards to physicians. These findings may help payers more effectively design and implement financial rewards for quality.
authors: Center for Health Quality, Outcomes & Economic Research, ENRM Veterans Hospital, Bedford, MA 01730, USA. bokhour@bu.edu
authors: Barbara G
authors: BG
authors: Bokhour
authors: James F
authors: JF
authors: Burgess
authors: Julie M
authors: JM
authors: Hook
authors: Bert
authors: B
authors: White
authors: Dan
authors: D
authors: Berlowitz
authors: Matthew R
authors: MR
authors: Guldin
authors: Mark
authors: M
authors: Meterko
authors: Gary J
authors: GJ
authors: Young