JCAHO - Principles for the Construct of Pay-for-Performance Programs

www.jcaho.org/.../pay_for_performance.htm

In recent years, thought leaders and policy-makers have directed increased attention to strategies for achieving system-wide improvements in health care quality and patient safety that will lead to larger-scale, more rapid changes in professional and provider behavior than have been experienced to date. To achieve such extraordinary progress, they have chosen to promote and leverage experimentation in programs that offer structured incentives for practitioners and providers to achieve benchmarks of performance.

The hope is that by offering positive rewards – both for reaching thresholds of performance and for making continuous strides in improving the quality of health care – high quality health care will be delivered on a consistent basis. This approach acknowledges the reality that financial rewards are among the most powerful tools for bringing about behavior change.

Notwithstanding their recent proliferation, pay-for-performance programs are largely untested. It is important that these programs be well-designed, make every effort to encompass all affected stakeholders for whom the incentives must be aligned, and be designed and implemented in a manner that engenders, maintains, and continually promotes trust among all of the participating parties.