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How to Learn What Clinicians and Policy Makers Need to Know

R. Adams Dudley, MD, MBA

JAMA. 2005;294:1821-1823.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Pay-for-performance has become increasingly common in health care. According to recent surveys, almost 100 pay-for-performance initiatives nationwide are now sponsored by a variety of health plans, employer coalitions, and government purchasers that are intended to improve the quality of care provided.¹

However, the rationale for pay-for-performance comes almost entirely from experience with incentives in other industries. Only 9 randomized controlled trials (RCTs) of pay-for-performance have been reported in the literature.² Even these studies are not clearly applicable to current pay-for-performance because they all focus on performance for a single indicator or a single aspect of care (eg, preventive care), whereas most current pay-for-performance initiatives use multiple indicators for multiple conditions and types of care.¹ Moreover, most studies have important flaws in reporting, such as the failure to note the market share of the organization offering the incentive in the practices of the providers being studied. . . . [Full Text of this Article]

Study Design

Author Affiliation: Institute for Health Policy Studies and Department of Medicine, University of California, San Francisco.

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