Can You Get What You Pay For? Pay-for-Performance and the Quality of Healthcare Providers
Kathleen J. Mullen
Richard G. Frank
Harvard Medical School; National Bureau of Economic Research (NBER)
Meredith B. Rosenthal
Harvard University - Harvard School of Public Health
April 14, 2009
RAND Working Paper Series No. WR- 680
Despite the popularity of pay-for-performance (P4P) among health policymakers and private insurers as a tool for improving quality of care, there is little empirical basis for its effectiveness. The authors use data from published performance reports of physician medical groups contracting with a large network HMO to compare clinical quality before and after the implementation of P4P, relative to a control group. They consider the effect of P4P on both rewarded and unrewarded dimensions of quality. In the end, they fail to find evidence that a large P4P initiative either resulted in major improvement in quality or notable disruption in care.
Number of Pages in PDF File: 43
Keywords: pay-for-performance, healthcare, quality, multitasking
JEL Classification: D23, I12, H51
Date posted: April 16, 2009
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