An Environmental Scan of Pay for Performance in the Hospital Setting: Final Report. Payment Mechanisms


  • What types of incentives, financial or non-financial, currently exist or are under consideration (e.g., financial, public recognition, public reporting, confidential peer comparisons, systems support)?
  •  How effective are different types of incentives at influencing provider behavior?
  •  Should incentives be based on thresholds, improvement, and/or high achievement? If based on relative performance, what characteristics define the relative peer group for comparison?
  •  What types of hospital providers are eligible for the rewards?
  •  What are the methods of delivery of financial rewards (e.g., differential, lump sum)?
  •  What is the timeframe for reward delivery (e.g., annual, quarterly)?
  •  For financial awards applied to service payments, are they applied to all services, measured services, and/or related services?
  •  What is the source of funding?
  •  What levels (fixed dollar, percent of payments) and types (negative versus positive) of financial incentives have been used or are under consideration? For those they have been used, what is the relationship between the levels and types of incentives and provider behavior?
  •  If applicable, how have operational issues (e.g., claims processing) impacted P4P programs?
  •  What mechanisms currently foster program integrity? What program integrity issues have occurred? What are potential program integrity issues initially and over time? 

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"PayPerform07.pdf" (pdf, 1.22Mb)

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