Tim Doran, M.D., Evangelos Kontopantelis, Ph.D., Jose M. Valderas, L.S.M., M.P.H., Ph.D., Stephen Campbell, M.A., Ph.D., Martin Roland, M.A., D.R.C.O.G., D.M., Chris Salisbury, M.B., Ch.B., M.Sc., and David Reeves, Ph.D. Journal: BMJ, published online June 2, 2011
T. Doran, E. Kontopantelis, J. M. Valderas et al., "Effect of Financial Incentives on Incentivized and Non-Incentivized Clinical Activities: Longitudinal Analysis of Data from the UK Quality and Outcomes Framework," BMJ, published online June 28, 2011.
Pay-for-performance arrangements in health care that reward providers for improvement on certain clinical activities may have the unintended consequence of diverting attention from other, unrewarded tasks.
Researchers designed a study using the United Kingdom's Quality and Outcomes Framework, which seeks to enhance health care providers' performance by linking 25 percent of their income to indicators of quality, care organization, and patient experience. They compared changes in provider performance on measures that were part of the incentive program, as well as performance changes in measures for which providers did not receive incentives.
Findings illustrate the limitations of financial incentive programs in health care and the importance of monitoring activities that are not incentivized, as well as those that are, when determining such programs’ success or failure.