Pay for performance programs in Australia: A need for guiding principles

Scott, Ian A. (2008) Pay for performance programs in Australia: A need for guiding principles. Australian Health Review, 32 4: 740-749.

Author Scott, Ian A.
Title Pay for performance programs in Australia: A need for guiding principles
Journal name Australian Health Review   Check publisher's open access policy
ISSN 0156-5788
Publication date 2008-11
Sub-type Article (original research)
Volume 32
Issue 4
Start page 740
End page 749
Total pages 10
Place of publication Collingwood, VIC, Australia
Publisher C S I R O Publishing
Language eng
Subject 1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Formatted abstract
Pay-for-performance (P4P) programs which reward clinical providers with incentive payments based on one or more measures of quality of care are now common in the United States and the United Kingdom and it is likely they will attract increasing interest in Australia. However, empirical evidence demonstrating effectiveness of such programs is limited and many existing programs have not had rigorous outcome evaluation. To maximise success, future P4P programs should incorporate the lessons and insights obtained from previous experience.

Based on a review of published trials, program evaluations and position statements, the following principles that may guide future program design and implementation were synthesised: 1) formulate a rationale and a business case for P4P; 2) use established evidence based performance measures; 3) use rigorous and verifiable methods of data collection and analysis; 4) define performance targets using absolute and relative thresholds; 5) use rewards that are sufficient, equitable and transparent; 6) address appropriateness of provider responses and avoid perverse incentives; 7) implement communication and feedback strategies; 8) use existing organisational structures to implement P4P programs; 9) attribute credit for performance to participants in ways that foster population-based perspectives; and 10) invest in outcomes and health service research.

Recommendations flowing from these principles relevant to Australian settings are provided.
Keyword Pay-for-performance
Outcome evaluation
Human services
Human resources
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 1 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 2 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Thu, 07 Jan 2010, 15:08:00 EST by Elissa Saffery on behalf of Faculty Of Health Sciences