Is the Evidence on the Effectiveness of Pay for Performance Schemes in Healthcare Changing? Evidence from a Meta-regression Analysis

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2021 Feb 25

PMID 33627112

Citations 11

Authors

Arezou Zaresani

Anthony Scott

Affiliations

Soon will be listed here.

Abstract

Background: This study investigated if the evidence on the success of the Pay for Performance (P4P) schemes in healthcare is changing as the schemes continue to evolve by updating a previous systematic review.

Methods: A meta-regression analysis using 116 studies evaluating P4P schemes published between January 2010 to February 2018. The effects of the research design, incentive schemes, use of incentives, and the size of the payment to revenue ratio on the proportion of statically significant effects in each study were examined.

Results: There was evidence of an increase in the range of countries adopting P4P schemes and weak evidence that the proportion of studies with statistically significant effects have increased. Factors hypothesized to influence the success of schemes have not changed. Studies evaluating P4P schemes which made payments for improvement over time, were associated with a lower proportion of statistically significant effects. There was weak evidence of a positive association between the incentives' size and the proportion of statistically significant effects.

Conclusion: The evidence on the effectiveness of P4P schemes is evolving slowly, with little evidence that lessons are being learned concerning the design and evaluation of P4P schemes.

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References

Michel-Lepage A, Ventelou B . The true impact of the French pay-for-performance program on physicians' benzodiazepines prescription behavior. Eur J Health Econ. 2015; 17(6):723-32. DOI: 10.1007/s10198-015-0717-6. View

Katz A, Enns J, Chateau D, Lix L, Jutte D, Edwards J . Does a pay-for-performance program for primary care physicians alleviate health inequity in childhood vaccination rates?. Int J Equity Health. 2015; 14:114. PMC: 4663722. DOI: 10.1186/s12939-015-0231-6. View

Peabody J, Shimkhada R, Quimbo S, Solon O, Javier X, McCulloch C . The impact of performance incentives on child health outcomes: results from a cluster randomized controlled trial in the Philippines. Health Policy Plan. 2013; 29(5):615-21. PMC: 4124243. DOI: 10.1093/heapol/czt047. View

Engineer C, Dale E, Agarwal A, Agarwal A, Alonge O, Edward A . Effectiveness of a pay-for-performance intervention to improve maternal and child health services in Afghanistan: a cluster-randomized trial. Int J Epidemiol. 2016; 45(2):451-9. DOI: 10.1093/ije/dyv362. View

Chen H, Huang N, Chen L, Chou Y, Li C, Wu C . Does Pay-For-Performance Program Increase Providers Adherence to Guidelines for Managing Hepatitis B and Hepatitis C Virus Infection in Taiwan?. PLoS One. 2016; 11(8):e0161002. PMC: 4982614. DOI: 10.1371/journal.pone.0161002. View

Cattel D, Eijkenaar F . Value-Based Provider Payment Initiatives Combining Global Payments With Explicit Quality Incentives: A Systematic Review. Med Care Res Rev. 2019; 77(6):511-537. PMC: 7536531. DOI: 10.1177/1077558719856775. View

Song Z, Fendrick A, Safran D, Landon B, Chernew M . Global Budgets and Technology-Intensive Medical Services. Healthc (Amst). 2014; 1(1-2):15-21. PMC: 3997740. DOI: 10.1016/j.hjdsi.2013.04.003. View

de Walque D, Gertler P, Bautista-Arredondo S, Kwan A, Vermeersch C, de Dieu Bizimana J . Using provider performance incentives to increase HIV testing and counseling services in Rwanda. J Health Econ. 2015; 40:1-9. DOI: 10.1016/j.jhealeco.2014.12.001. View

Sutton M, Nikolova S, Boaden R, Lester H, McDonald R, Roland M . Reduced mortality with hospital pay for performance in England. N Engl J Med. 2012; 367(19):1821-8. DOI: 10.1056/NEJMsa1114951. View

10.

Asch D, Troxel A, Stewart W, Sequist T, Jones J, Hirsch A . Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels: A Randomized Clinical Trial. JAMA. 2015; 314(18):1926-35. PMC: 5509443. DOI: 10.1001/jama.2015.14850. View

11.

Allen T, Fichera E, Sutton M . Can Payers Use Prices to Improve Quality? Evidence from English Hospitals. Health Econ. 2014; 25(1):56-70. DOI: 10.1002/hec.3121. View

12.

Swaminathan S, Mor V, Mehrotra R, Trivedi A . Effect of Medicare dialysis payment reform on use of erythropoiesis stimulating agents. Health Serv Res. 2014; 50(3):790-808. PMC: 4450930. DOI: 10.1111/1475-6773.12252. View

13.

Chen T, Hsueh Y, Ko C, Shih L, Yang S . The effect of a hepatitis pay-for-performance program on outcomes of patients undergoing antiviral therapy. Eur J Public Health. 2017; 27(6):955-960. DOI: 10.1093/eurpub/ckx114. View

14.

Pan C, Kung P, Chiu L, Liao Y, Tsai W . Patients with diabetes in pay-for-performance programs have better physician continuity of care and survival. Am J Manag Care. 2017; 23(2):e57-e66. View

15.

Gavagan T, Du H, Saver B, Adams G, Graham D, McCray R . Effect of financial incentives on improvement in medical quality indicators for primary care. J Am Board Fam Med. 2010; 23(5):622-31. DOI: 10.3122/jabfm.2010.05.070187. View

16.

Unutzer J, Chan Y, Hafer E, Knaster J, Shields A, Powers D . Quality improvement with pay-for-performance incentives in integrated behavioral health care. Am J Public Health. 2012; 102(6):e41-5. PMC: 3483954. DOI: 10.2105/AJPH.2011.300555. View

17.

Bastian N, Kang H, Nembhard H, Bloschichak A, Griffin P . The Impact of a Pay-for-Performance Program on Central Line-Associated Blood Stream Infections in Pennsylvania. Hosp Top. 2016; 94(1):8-14. DOI: 10.1080/00185868.2015.1130542. View

18.

Serumaga B, Ross-Degnan D, Avery A, Elliott R, Majumdar S, Zhang F . Effect of pay for performance on the management and outcomes of hypertension in the United Kingdom: interrupted time series study. BMJ. 2011; 342:d108. PMC: 3026849. DOI: 10.1136/bmj.d108. View

19.

Sicsic J, Franc C . Impact assessment of a pay-for-performance program on breast cancer screening in France using micro data. Eur J Health Econ. 2016; 18(5):609-621. DOI: 10.1007/s10198-016-0813-2. View

20.

Binyaruka P, Patouillard E, Powell-Jackson T, Greco G, Maestad O, Borghi J . Effect of Paying for Performance on Utilisation, Quality, and User Costs of Health Services in Tanzania: A Controlled Before and After Study. PLoS One. 2015; 10(8):e0135013. PMC: 4552688. DOI: 10.1371/journal.pone.0135013. View