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October 8, 2008

Comparisons of Safety-Net and Non–Safety-Net Hospitals

JAMA. 2008;300(14):1650-1652. doi:10.1001/jama.300.14.1650-b

To the Editor: In their study comparing change in quality of care between safety-net and non–safety-net hospitals, Dr Werner and colleagues1 raised important points about the design of pay-for-performance programs linked to publicly reported quality measures and the risk of unintended negative consequences to financially strapped public hospitals. I agree with their caveats about zero sum financial incentives.