Quality of health care improved by pay-for-performance?

Among 17 studies recently reviewed, five out of six studies of physician-level financial incentives and seven out of nine studies of group-level incentives showed a partial or positive effect on the quality of care. One of two studies of payment-system level incentives had a positive effect on access to care, while the other had a negative effect. In total, four of the 17 showed unintended consequences from incentives.

Based on these findings, the researchers, whose work was published in the Annals of Internal Medicine (8/15/2006), found that few generalizations could be made. However, they did note that programs using financial incentives often do produce a response, although the response may be an unintended one. The researchers offered a few tips when designing such programs to achieve an intended goal: