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

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