Can You Get What You Pay For? Pay-for-Performance and the Quality of Healthcare Providers

43 Pages Posted: 16 Apr 2009  

Kathleen J. Mullen

RAND Corporation

Richard G. Frank

Harvard Medical School; National Bureau of Economic Research (NBER)

Meredith B. Rosenthal

Harvard University - T.H. Chan School of Public Health

Multiple version iconThere are 2 versions of this paper

Date Written: April 14, 2009

Abstract

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.

Keywords: pay-for-performance, healthcare, quality, multitasking

JEL Classification: D23, I12, H51

Suggested Citation

Mullen, Kathleen J. and Frank, Richard G. and Rosenthal, Meredith B., Can You Get What You Pay For? Pay-for-Performance and the Quality of Healthcare Providers (April 14, 2009). RAND Working Paper Series No. WR- 680. Available at SSRN: https://ssrn.com/abstract=1381463 or http://dx.doi.org/10.2139/ssrn.1381463

Kathleen J. Mullen (Contact Author)

RAND Corporation ( email )

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Richard G. Frank

National Bureau of Economic Research (NBER)

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Harvard Medical School ( email )

Department of Health Care Policy
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United States
617-432-0178 (Phone)
617-432-1219 (Fax)

Meredith B. Rosenthal

Harvard University - T.H. Chan School of Public Health ( email )

677 Huntington Avenue
Boston, MA 02115
United States

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