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

Mullen, Kathleen J.; Frank, Richard G.; Rosenthal, Meredith B.

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

NBER Working Paper No. w14886

43 Pages Posted: 20 Apr 2009 Last revised: 1 Mar 2024

See all articles by Kathleen J. Mullen

Richard G. Frank

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

Meredith B. Rosenthal

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

There 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: 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