Pay-for-performance in health care: what can we learn from international experience?
Wilson, K.J.
Quality Management in Health Care 22(1): 2-15
2013
ISSN/ISBN: 1063-8628 PMID: 23271589 DOI: 10.1097/qmh.0b013e31827dea50Document Number: 214719
As industrialized countries around the world encounter rising health care costs with little to show in quality and health outcome improvements, they increasingly are turning to pay-for-performance mechanisms to align provider action with quality, equity, and efficiency goals. The primary objective of most pay-for-performance schemes is to improve quality of care, and the logic of linking financial rewards to quality and performance metrics makes sense. However, despite broad international experience with pay-for-performance, evidence of its impact is limited, frequently conflicting, focuses largely on improvements in the provision and structure of care rather than health outcomes, and tends to generate more questions than it does answers.