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Conceptual Issues in the Design and Implementation of Pay-for-Quality Programs

Center for Organization, Leadership and Management Research, Department of Veterans Affairs, Boston University School of Public Health, health{at}bu.edu

Bert White, MBA, DMin

Boston University School of Public Health

James F. Burgess, Jr, PhD

Management Sciences Group, Department of Veterans Affairs, Boston University School of Public Health

Dan Berlowitz, MD

Center for Health Quality, Outcomes, and Economic Research, Boston University School of Public Health

Mark Meterko, PhD

Center for Organization, Leadership and Management Research, Department of Veterans Affairs

Matthew R. Guldin

Boston University School of Public Health

Barbara G. Bokhour, PhD

Center for Health Quality, Outcomes, and Economic Research, Boston University School of Public Health

This article identifies and discusses key conceptual issues in designing and implementing pay-for-quality programs. Such programs offer financial incentives to providers for achieving predefined quality targets. The purpose of the article is to provide health care professionals with a framework for designing, implementing, and evaluating pay-for-quality programs. Examples are drawn from the Rewarding Results demonstration project for which the authors serve as the national evaluation team.

Key Words: quality • financial incentives • pay-for-performance • payment methods

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