Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Lessons From Healthcare Providers' Attitudes Toward Pay-for-performance: What Should Purchasers Consider in Designing and Implementing a Successful Program?

  • Lee, Jin-Yong (Department of Preventive Medicine, Konyang University College of Medicine) ;
  • Lee, Sang-Il (Department of Preventive Medicine, University of Ulsan College of Medicine) ;
  • Jo, Min-Woo (Department of Preventive Medicine, University of Ulsan College of Medicine)
  • Received : 2012.01.31
  • Accepted : 2012.05.15
  • Published : 2012.05.31
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Abstract

We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and then read the full version of the screened articles for the final selections. In addition, one reference of screened articles and one unpublished report were also included. Therefore, 14 articles were included in this study. Healthcare providers' attitudes on P4P were summarized in two ways. First, we gathered their general attitudes and opinions regarding the effects of P4P. Second, we rearranged their opinions regarding desirable P4P design and implementation methods, as well as their concerns. This study showed the possibility that some healthcare providers still have a low level of awareness about P4P and might prefer voluntary participation in P4P. In addition, they felt that adequate quality indicators and additional support for implementation of P4P would be needed. Most healthcare providers also had serious concerns that P4P would induce unintended consequences. In order to conduct successful implementation of P4P, purchaser should make more efforts such as increasing providers' level of awareness about P4P, providing technical and educational support, reducing their burden, developing a cooperative relationship with providers, developing more accurate quality measures, and minimizing the unintended consequences.

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References

  1. Spitzer AR. Pay for performance in neonatal-perinatal medicine: will the quality of health care improve in the neonatal intensive care unit? A business model for improving outcomes in the neonatal intensive care unit. Clin Perinatol 2010;37(1):167-177.
  2. Organization for Economic Cooperation and Development. Value for money in health spending. Paris: Organization for Economic Cooperation and Development; 2010, p. 105-123.
  3. Epstein AM. Paying for performance in the United States and abroad. N Engl J Med 2006;355(4):406-408.
  4. Dudley RA. Pay-for-performance research: how to learn what clinicians and policy makers need to know. JAMA 2005;294(14):1821-1823.
  5. Rosenthal MB, Frank RG, Li Z, Epstein AM. Early experience with pay-for-performance: from concept to practice. JAMA 2005;294(14):1788-1793.
  6. Organization for Economic Cooperation and Development. Improving value in heath care: measuring quality. Forum on quality of care; 2010 [cited 2011 Jan 21]. Available from: http://www.oecd.org/dataoecd/14/27/46098506.pdf.
  7. Integrated Healthcare Association. Pay for performance overview [cited 2011 Mar 23]. Available from: http://www.iha.org/pay_performance.html.
  8. Pearson SD, Schneider EC, Kleinman KP, Coltin KL, Singer JA. The impact of pay-for-performance on health care quality in Massachusetts, 2001-2003. Health Aff (Millwood) 2008;27(4):1167-1176.
  9. Centers for Medicaid Services. Premier hospital quality incentive demonstration project: project findings from year two; 2007 [cited 2012 Jan 25]. Available from: http://www. premierinc.com/quality-safety/tools-services/p4p/ hqi/resources/hqi-whitepaper-year2.pdf.
  10. Centers for Medicaid Services. Medicare physician group practice demonstration fact sheet; 2011 [cited 2012 May 25]. Available from: https://www.cms.gov/Medicare/ Demonstration-Projects/DemoProjectsEvalRpts/ downloads/PGP_Fact_Sheet.pdf.
  11. Peckham S. The new general practice contract and reform of primary care in the United Kingdom. Healthc Policy 2007;2(4):34-48.
  12. Medicare Australia. Practice incentive program (PIP) [cited 2011 Mar 23]. Available from: http://www.medicareaustralia.gov.au/provider/incentives/pip/index.jsp.
  13. Gilmore AS, Zhao Y, Kang N, Ryskina KL, Legorreta AP, Taira DA, et al. Patient outcomes and evidence-based medicine in a preferred provider organization setting: a sixyear evaluation of a physician pay-for-performance program. Health Serv Res 2007;42(6 Pt 1):2140-2159.
  14. Armour BS, Friedman C, Pitts MM, Wike J, Alley L, Etchason J. The influence of year-end bonuses on colorectal cancer screening. Am J Manag Care 2004;10(9):617-624.
  15. Foels T, Hewner S. Integrating pay for performance with educational strategies to improve diabetes care. Popul Health Manag 2009;12(3):121-129.
  16. Campbell SM, Reeves D, Kontopantelis E, Sibbald B, Roland M. Effects of pay for performance on the quality of primary care in England. N Engl J Med 2009;361(4):368-378
  17. Hillman AL, Ripley K, Goldfarb N, Nuamah I, Weiner J, Lusk E. Physician financial incentives and feedback: failure to increase cancer screening in Medicaid managed care. Am J Public Health 1998;88(11):1699-1701.
  18. Shen Y. Selection incentives in a performance-based contracting system. Health Serv Res 2003;38(2):535-552.
  19. Hedgecoe AM. It's money that matters: the financial context of ethical decision-making in modern biomedicine. Sociol Health Illn 2006;28(6):768-784.
  20. Mansfield RJ. P4P is changing me. Med Econ 2007;84(9): 56, 60.
  21. Werner RM, Goldman LE, Dudley RA. Comparison of change in quality of care between safety-net and nonsafety- net hospitals. JAMA 2008;299(18):2180-2187.
  22. Relman AS. Medical professionalism in a commercialized health care market. JAMA 2007;298(22):2668-2670.
  23. Dudley RA, Rosenthal MB. Pay for performance: a decision guide for purchasers. Final contract report. Rockville: Agency for Healthcare Research and Quality; 2006, p. 1-28.
  24. Murphy KM, Nash DB. Nonprimary care physicians' views on office-based quality incentive and improvement programs. Am J Med Qual 2008;23(6):427-439.
  25. Centers for Medicare and Medicaid Services. State medicaid director letter. No. 06-003, 6 April 2006.
  26. Eichler R, De S. Paying for performance in health: guide to developing the blueprint; 2008 [cited 2010 Feb 17]. Available from: http://pdf.usaid.gov/pdf_docs/PNADN760.pdf.
  27. Oxman AD, Fretheim A. An overview of research on the effects of results-based financing; 2008 [cited 2010 Feb 17]. Available from: http://hera.helsebiblioteket.no/hera/ bitstream/10143/33892/1/NOKCrapport16_2008.pdf.
  28. McDonald R, Roland M. Pay for performance in primary care in England and California: comparison of unintended consequences. Ann Fam Med 2009;7(2):121-127.
  29. Lee SI, Kim NS, Lee JY, Jo MW, Kim SH, Son WS, et al. Development of pay-for-performance model for quality assessment items in medical care benefit. Seoul: Health Insurance Review and Assessment Service; 2010, p.109-139 (Korean).
  30. Young GJ, Burgess JF Jr, White B. Pioneering pay-forquality: lessons from the rewarding results demonstrations. Health Care Financ Rev 2007;29(1):59-70.
  31. Erekson EA, Sung VW, Clark MA. Pay-for-performance: a survey of specialty providers in urogynecology. J Reprod Med 2011;56(1-2):3-11.
  32. Casalino LP, Alexander GC, Jin L, Konetzka RT. General internists' views on pay-for-performance and public reporting of quality scores: a national survey. Health Aff (Millwood) 2007;26(2):492-499.
  33. Natale JE, Joseph JG, Honomichl RD, Bazanni LG, Kagawa KJ, Marcin JP. Benchmarking, public reporting, and pay-for-performance: a mixed-methods survey of California pediatric intensive care unit medical directors. Pediatr Crit Care Med 2011;12(6):e225-e232.
  34. Damberg CL, Raube K, Teleki SS, Dela Cruz E. Taking stock of pay-for-performance: a candid assessment from the front lines. Health Aff (Millwood) 2009;28(2):517-525.
  35. Pines JM, Hollander JE, Lee H, Everett WW, Uscher- Pines L, Metlay JP. Emergency department operational changes in response to pay-for-performance and antibiotic timing in pneumonia. Acad Emerg Med 2007;14(6):545-548.
  36. Locke RG, Srinivasan M. Attitudes toward pay-forperformance initiatives among primary care osteopathic physicians in small group practices. J Am Osteopath Assoc 2008;108(1):21-24.
  37. Steiger B. Poll finds physicians very wary of pay-forperformance programs. Physician Exec 2005;31(6):6-11.
  38. Reiter KL, Nahra TA, Alexander JA, Wheeler JR. Hospital responses to pay-for-performance incentives. Health Serv Manage Res 2006;19(2):123-134.
  39. Kaczorowski J, Goldberg O, Mai V. Pay-for-performance incentives for preventive care: views of family physicians before and after participation in a reminder and recall project (P-PROMPT). Can Fam Physician 2011;57(6):690-696.
  40. Goldman LE, Henderson S, Dohan DP, Talavera JA, Dudley RA. Public reporting and pay-for-performance: safety-net hospital executives' concerns and policy suggestions. Inquiry 2007;44(2):137-145.
  41. Young G, Meterko M, White B, Sautter K, Bokhour B, Baker E, et al. Pay-for-performance in safety net settings: issues, opportunities, and challenges for the future. J Healthc Manag 2010;55(2):132-141.
  42. McDonald R, White J, Marmor TR. Paying for performance in primary medical care: learning about and learning from "success" and "failure" in England and California. J Health Polit Policy Law 2009;34(5):747-776.
  43. Van Herck P, De Smedt D, Annemans L, Remmen R, Rosenthal MB, Sermeus W. Systematic review: effects, design choices, and context of pay-for-performance in health care. BMC Health Serv Res 2010;10:247.
  44. Healy J, Braithwaite J. Designing safer health care through responsive regulation. Med J Aust 2006;184(10 Suppl):S56-S59.

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