Published Research

Pay for Performance in Health Care: Methods and Approaches

Edited By: Cromwell, J., Trisolini, M.G., Pope, G.C., Mitchell, J.B., Greenwald, L.M.

This book provides a balanced assessment of pay for performance (P4P), addressing both its promise and its shortcomings. P4P programs have become widespread in health care in just the past decade and have generated a great deal of enthusiasm in health policy circles and among legislators, despite limited evidence of their effectiveness. On a positive note, this movement has developed and tested many new types of health care payment systems and has stimulated much new thinking about how to improve quality of care and reduce the costs of health care. The current interest in P4P echoes earlier enthusiasms in health policy—such as those for capitation and managed care in the 1990s—that failed to live up to their early promise. The fate of P4P is not yet certain, but we can learn a number of lessons from experiences with P4P to date, and ways to improve the designs of P4P programs are becoming apparent. We anticipate that a “second generation” of P4P programs can now be developed that can have greater impact and be better integrated with other interventions to improve the quality of care and reduce costs.

Download by Chapters

Introduction
Chapter 1. Introduction to Pay for Performance
Chapter 2. Overview of Pay for Performance Models and Issues
Chapter 3. Theoretical Perspectives on Pay for Performance
Chapter 4. Quality Measures for Pay for Performance
Chapter 5. Incorporating Efficiency Measures into Pay for Performance
Chapter 6. Who Gets the Payment Under Pay for Performance?
Chapter 7. Attributing Patients to Physicians for Pay for Performance
Chapter 8. Financial Gains and Risks in Pay for Performance Bonus Algorithms
Chapter 9. Overview of Selected Medicare Pay for Performance Demonstrations
Chapter 10. Evaluating Pay for Performance Interventions
Chapter 11. Converting Successful Medicare Demonstrations into National Programs
Chapter 12. Conclusions: Planning for Second-Generation Pay for Performance
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