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Understanding the intervention and implementation factors associated with benefits and harms of pay for performance programs in healthcare

Author: Karli Kondo; United States. Department of Veterans Affairs. Health Services Research and Development Service,; Quality Enhancement Research Initiative (U.S.),; Portland VA Medical Center. Evidence-based Synthesis Program Center,
Publisher: Washington (DC) : Department of Veterans Affairs, Health Services Research & Development Service, May 2015.
Series: Evidence-based synthesis program (Series)
Edition/Format:   eBook : Document : National government publication : English
Summary:
Over the last decade, pay for performance (P4P) programs have been implemented in a variety of health systems, including the VHA, as a means to improve the efficiency and quality of health care. There has been a parallel increase in the number of studies examining the effects of P4P. A number of recent reviews have summarized this literature, but have generally found insufficient evidence to broadly characterize the  Read more...
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Genre/Form: Review
Material Type: Document, Government publication, National government publication, Internet resource
Document Type: Internet Resource, Computer File
All Authors / Contributors: Karli Kondo; United States. Department of Veterans Affairs. Health Services Research and Development Service,; Quality Enhancement Research Initiative (U.S.),; Portland VA Medical Center. Evidence-based Synthesis Program Center,
OCLC Number: 947741165
Description: 1 online resource (1 PDF file (vi, 153 pages)) : illustrations.
Series Title: Evidence-based synthesis program (Series)
Responsibility: principal investigator, Karli Kondo ; contributing investigators, Cheryl Damberg, Aaron Mendelson, Makalapua Motu'apuaka, Michele Freeman, Maya O'Neil, Rose Relevo, Devan Kansagara.

Abstract:

Over the last decade, pay for performance (P4P) programs have been implemented in a variety of health systems, including the VHA, as a means to improve the efficiency and quality of health care. There has been a parallel increase in the number of studies examining the effects of P4P. A number of recent reviews have summarized this literature, but have generally found insufficient evidence to broadly characterize the balance of harms and benefits. However, financial incentives programs are complex interventions whose effects may depend in part on the settings in which they are implemented, the methods used for implementation, the populations targeted, and the characteristics of the incentive programs themselves. The objectives of this report are to summarize the positive and negative effects of P4P on process and health outcomes, and to examine how implementation characteristics modify the effects of P4P programs. The Key Questions used to guide our report are: Key Question 1: What are the effects of pay for performance programs on patient outcomes and processes of care? Key Question 2: What implementation factors modify the effectiveness of pay for performance? Key Question 3: What are the positive and negative unintended consequences, including any effect on health disparities, associated with pay for performance?

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