Healthy Skepticism Library item: 12769

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Publication type: Journal Article

Mannion R, Davies HTO.
Payment for performance in health care
BMJ 2008 Feb 9; 336:(7639):306-8
http://www.bmj.com/cgi/content/extract/336/7639/306?etoc

Abstract:

Health service pay is top of the political and media agenda in many countries. In the UK, moral outrage over doctors’ pay – fuelled by the lay media – has contributed to a widespread belief that pay rises have soaked up much of the recent investment in the NHS.1 Doctors’ representatives respond that rising pay reflects rising quality and performance, but doubts remain and even the government has expressed alarm, threatening to cap future rises. Other countries are also grappling with how to pay healthcare professionals, particularly doctors.

Pay and performance
Many countries have linked the remuneration problem with concerns about quality and performance, focusing new attention on payment for performance programmes. Under these programmes a portion of payment is dependent on performance assessed against one or more defined measures.2 The United States has over 100 private and federal Medicare reward and incentive programmes,3 and Italy and New Zealand are beginning to reward . . .