title: Can you get what you pay for? Pay-for-performance and the quality of healthcare providers.
abstract: Despite the popularity of pay-for-performance (P4P) among health policymakers and private insurers as a tool for improving quality of care, there is little empirical basis for its effectiveness. We use data from published performance reports of physician medical groups contracting with a large network HMO to compare clinical quality before and after the implementation of P4P, relative to a control group. We consider the effect of P4P on both rewarded and unrewarded dimensions of quality. In the end, we fail to find evidence that a large P4P initiative either resulted in major improvement in quality or notable disruption in care.
authors.affiliation: RAND Corporation, USA. kmullen@rand.org
authors.forename: Kathleen J
authors.initials: KJ
authors.lastname: Mullen
authors.forename: Richard G
authors.initials: RG
authors.lastname: Frank
authors.forename: Meredith B
authors.initials: MB
authors.lastname: Rosenthal
mesh_terms: D003695:Delivery of Health Care / Q000191:economics*; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D008962:Models, Theoretical; D011785:Quality Assurance, Health Care / Q000191:economics* / Q000706:statistics & numerical data; D012052:Reimbursement, Incentive / Q000191:economics*; D014481:United States