Health Care Professionals' Perceptions of Pay-for-Performance in Practice: A Qualitative Metasynthesis. (May 2020)

• Record Type: Journal Article
• Authors: Martin, Barbara; Jones, Jacqueline; Miller, Matthew; Johnson-Koenke, Rachel
• Is Part Of: Inquiry. Volume 57(2020)
• Publication Date: 2020-05
• Subjects: pay-for-performance -- incentive payments -- value-based payment models -- physician engagement -- health care professional engagement -- intrinsic motivation -- quality measurement; Medical policy -- United States -- Periodicals; Medical care, Cost of -- United States -- Periodicals; Hospitalization insurance -- United States -- Periodicals; 362.10973
• DOI: 10.1177/0046958020917491
• Languages: English
• ISSNs: 0046-9580

Abstract

Incentive-based pay-for-performance (P4P) models have been introduced during the last 2 decades as a mechanism to improve the delivery of evidence-based care that ensures clinical quality and improves health outcomes. There is mixed evidence that P4P has a positive effect on health outcomes and researchers cite lack of engagement from health care professionals as a limiting factor. This qualitative metasynthesis of existing qualitative research was conducted to integrate health care professionals' perceptions of P4P in clinical practice. Four themes emerged during the research process: positive perceptions of the value of performance measurement and associated financial incentives; negative perceptions of the performance measurement and associated financial incentives; perceptions of how P4P programs influence the quality/appropriateness of care; and perceptions of the influence of P4P program on professional roles and workplace dynamics. Identifying factors that influence health care professionals' perceptions about this type of value-based payment model will guide future research.