An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for Patients
Pay-for-performance (P4P) programs have been introduced into the Canadian medical system in the last decades. This paper examines the underlying characteristics of P4P and describes both their advantages and drawbacks. Most P4P programs provide the advantage of rewarding medical acts, thus providing...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/8943972 |
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| author | Kwadwo Kyeremanteng Raphaëlle Robidoux Gianni D’Egidio Shannon M. Fernando David Neilipovitz |
| author_facet | Kwadwo Kyeremanteng Raphaëlle Robidoux Gianni D’Egidio Shannon M. Fernando David Neilipovitz |
| author_sort | Kwadwo Kyeremanteng |
| collection | DOAJ |
| description | Pay-for-performance (P4P) programs have been introduced into the Canadian medical system in the last decades. This paper examines the underlying characteristics of P4P and describes both their advantages and drawbacks. Most P4P programs provide the advantage of rewarding medical acts, thus providing an incentive to take on complex patients. There is a variety of nuanced P4P initiatives, which provide financial incentive according to differing criteria, based on quality measures, incentives, and/or benchmark structures. However, there is no conclusive evidence demonstrating that P4P programs provide better value for money than traditional pay schemes, regardless of particular structural choices. Some evidence has even shown that P4P may be detrimental, especially in disadvantaged and high-risk populations. Additionally, there are a number of ethical and practical concerns that arise with the use of P4P, such as the risk of financial incentives being misused or misinterpreted and patients being refused or referred during treatment. P4P initiatives require careful examination and the creation of solid, evidence-based criteria for evaluation and implementation in Canadian medical systems. |
| format | Article |
| id | doaj-art-912ecc0bb7dc4bdf989850ecf90d6a00 |
| institution | OA Journals |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-912ecc0bb7dc4bdf989850ecf90d6a002025-08-20T02:09:42ZengWileyCritical Care Research and Practice2090-13052090-13132019-01-01201910.1155/2019/89439728943972An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for PatientsKwadwo Kyeremanteng0Raphaëlle Robidoux1Gianni D’Egidio2Shannon M. Fernando3David Neilipovitz4University of Ottawa, 75 Laurier Est, Ottawa, Ontario, K1N 6N5, CanadaUniversity of Ottawa, 75 Laurier Est, Ottawa, Ontario, K1N 6N5, CanadaUniversity of Ottawa, 75 Laurier Est, Ottawa, Ontario, K1N 6N5, CanadaQueen’s University, 99 University Avenue, Kingston, K7L 3N6, CanadaUniversity of Ottawa, 75 Laurier Est, Ottawa, Ontario, K1N 6N5, CanadaPay-for-performance (P4P) programs have been introduced into the Canadian medical system in the last decades. This paper examines the underlying characteristics of P4P and describes both their advantages and drawbacks. Most P4P programs provide the advantage of rewarding medical acts, thus providing an incentive to take on complex patients. There is a variety of nuanced P4P initiatives, which provide financial incentive according to differing criteria, based on quality measures, incentives, and/or benchmark structures. However, there is no conclusive evidence demonstrating that P4P programs provide better value for money than traditional pay schemes, regardless of particular structural choices. Some evidence has even shown that P4P may be detrimental, especially in disadvantaged and high-risk populations. Additionally, there are a number of ethical and practical concerns that arise with the use of P4P, such as the risk of financial incentives being misused or misinterpreted and patients being refused or referred during treatment. P4P initiatives require careful examination and the creation of solid, evidence-based criteria for evaluation and implementation in Canadian medical systems.http://dx.doi.org/10.1155/2019/8943972 |
| spellingShingle | Kwadwo Kyeremanteng Raphaëlle Robidoux Gianni D’Egidio Shannon M. Fernando David Neilipovitz An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for Patients Critical Care Research and Practice |
| title | An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for Patients |
| title_full | An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for Patients |
| title_fullStr | An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for Patients |
| title_full_unstemmed | An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for Patients |
| title_short | An Analysis of Pay-for-Performance Schemes and Their Potential Impacts on Health Systems and Outcomes for Patients |
| title_sort | analysis of pay for performance schemes and their potential impacts on health systems and outcomes for patients |
| url | http://dx.doi.org/10.1155/2019/8943972 |
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