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

43 Pages Posted: 20 Apr 2009 Last revised: 5 Sep 2010

See all articles by Kathleen J. Mullen

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 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. We 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. We consider the effect of P4P on both rewarded and unrewarded dimensions of quality. In the end, we fail to find evidence that a large P4P initiative either resulted in major improvement in quality or notable disruption in care.

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 2009). NBER Working Paper No. w14886. Available at SSRN: https://ssrn.com/abstract=1391833

Kathleen J. Mullen

RAND Corporation ( email )

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Richard G. Frank (Contact Author)

Harvard Medical School ( email )

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Boston, MA 02115
United States
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National Bureau of Economic Research (NBER)

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Meredith B. Rosenthal

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

677 Huntington Avenue
Boston, MA MA 02115
United States

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