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Commentary
May 14, 2008

The Wisdom and Justice of Not Paying for “Preventable Complications”

Author Affiliations

Author Affiliations: Departments of Anesthesiology and Critical Care Medicine (Dr Pronovost and Ms Goeschel), Surgery and Health Policy & Management (Dr Pronovost), and School of Nursing (Ms Goeschel), Johns Hopkins University, Baltimore, Maryland; and Division of Hospital Medicine, University of California, San Francisco (Dr Wachter).

JAMA. 2008;299(18):2197-2199. doi:10.1001/jama.299.18.2197

Far too many patients experience preventable harm from medical care in US hospitals. To promote quality and safety, many employers and insurers are linking financial incentives to clinical performance. These programs, often called pay for performance, use a carrot (pay more for better quality) or a stick (pay less for lower quality). To date, most pay-for-performance programs have encouraged physicians to use evidence-based interventions or improve patient satisfaction.1

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