Over the past decade, public and private payers have experimented with the use of financial incentives to motivate physicians to achieve quality and efficiency. The idea behind pay for performance is simple. Because individuals and organizations respond to incentives, physicians whose patients achieve desirable outcomes should be paid more as an incentive to improve their performance. Yet the results of pay-for-performance programs have been largely disappointing.1 One argument is that neither the right set of incentives nor the right set of metrics has been identified.2 Another explanation, which has received far less attention, is that the right set of patients has not been identified for targeted efforts.
McKethan A, Jha AK. Designing Smarter Pay-for-Performance Programs. JAMA. 2014;312(24):2617-2618. doi:10.1001/jama.2014.15398