Pay-for-Performance
Will the Latest Payment Trend Improve Care?
- Meredith B. Rosenthal, PhD;
- R. Adams Dudley, MD, MBA
- Author Affiliations: Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass (Dr Rosenthal); and Department of Medicine and Institute for Health Policy Studies, University of California, San Francisco (Dr Dudley).
- Corresponding Author: Meredith B. Rosenthal, PhD, Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115 (mrosenth{at}hsph.harvard.edu).
Since this article does not have an abstract, we have provided the first 150 words of the full text.
Pay-for-performance programs are now firmly ensconced in the payment systems of US public and private insurers across the spectrum. More than half of commercial health maintenance organizations are using pay-for-performance, and recent legislation requires Centers for Medicare & Medicaid Services (CMS) to adopt this approach for Medicare.1 As commercial programs have evolved during the last 5 years, the categories of providers (clinicians, hospitals, and other health care facilities), numbers of measures, and dollar amounts at risk have increased. In addition, acceptance of performance measurement among physicians and organized medicine has broadened, with the American Medical Association committing to the US Congress in February 2006 that it would develop more than 100 performance measures by the end of 2006.2
To date, widespread experimentation has yielded important lessons and highlighted critical challenges to paying for performance. Several recently published evaluations have demonstrated both the potential of pay-for-performance and the need …
