Pay for Performance: A Decision Guide for Purchasers


1. Baker G, Carter B. The evolution of pay for performance models for rewarding providers. Introduction to: Case Studies in Health Plan Pay-for-Performance. Washington, DC: Atlantic Information Services; 2004.

2. Casalino L, Gillies RR, Shortell SM, et al. External incentives, information technology, and organized processes to improve health care quality for patients with chronic diseases. Journal of the American Medical Association 2003;289(4):434-41.

3. The Leapfrog Group. Leapfrog Compendium. Accessed August 25, 2005.

4. Steiger, B. Poll finds physicians very wary of pay-for-performance programs. The Physician Executive, November/December 2005: 6-11.

5. Dudley RA, Frolich A, Robinowitz DL, et al. Strategies To Support Quality-based Purchasing: A Review of the Evidence. Technical Review 10. (Prepared by the Stanford-University of California San Francisco Evidence-based Practice Center under Contract No. 290-02-0017). AHRQ Publication No. 04-0057. Rockville, MD: Agency for Healthcare Research and Quality, July 2004.

6. Baker G. Pay for Performance Incentive Programs in Healthcare: Market Dynamics and Business Process. San Francisco, CA: Med-Vantage; 2004

7. Glied S, Zivin J. How do doctors behave when some (but not all) of their patients are in managed care? Journal of Health Economics 2002; 21(2): 337-53.

8. McGuire TG, Pauly MV. Physician responses to fee changes with multiple payers. Journal of Health Economics 1991; 10(4):385-410.

9. O’Brien E. Long-term care: understanding Medicaid’s role for the elderly and disabled. Washington, DC: Henry J. Kaiser Family Foundation. November 2005.

10. Neuhauser D, Harper DL. Too good to last: did Cleveland Health Quality Choice leave a legacy and lessons to be learned? Quality & Safety in Health Care 2002;11:202–3.

11. Medicare Payment Advisory Commission. Strategies to Improve Care: Pay for Performance and Information Technology. Chapter 4, Report to Congress: Medicare Payment Policy, March 2005.

12. Mehrotra A, Bodenheimer T, Dudley RA. Employers’ efforts to measure and improve hospital quality: determinants of success. Health Affairs (Millwood) 2003; 22(2):60-71.

13. National Health Foundation. Findings from the Survey of Hospital Performance Measurement Activities in California. Oakland, CA: California Healthcare Foundation. 2004.

14. Shearer A, Cronin C, Feeney D. The State-of-the-Art of Online Hospital Public Reporting: A Review of Forty-Seven Websites. Easton, MD: The Delmarva Foundation; 2004.

15 Werner RM, Asch DA. The unintended consequences of publicly reporting quality information. Journal of the American Medical Association 2005;293(10):1239-44.

16. Luce JM, Thiel GD, Holland MR, et al. Use of risk-adjusted outcome data for quality improvement by public hospitals. Western Journal of Medicine 1996;164(5):410-4.

17. Berwick DM, Wald DL. Hospital leaders' opinions of the HCFA mortality data. Journal of the American Medical Association 1990;263(2):247-9.

18. Romano PS, Rainwater JA, Antonius D. Grading the graders: how hospitals in California and New York perceive and interpret their report cards. Medical Care 1999;37(3):295-305.

19. Jones RH, Hannan EL, Hammermeister KE, et al. Identification of preoperative variables needed for risk adjustment of short-term mortality after coronary artery bypass graft surgery. The Working Group Panel on the Cooperative CABG Database Project. Journal of the American College of Cardiology 1996;28(6):1478-87.

20. Agency for Healthcare Research and Quality. 2005 National Healthcare Quality Report. Rockville, MD: Department of Health and Human Services, Agency for Healthcare Research and Quality; 2005.

21. Institute of Medicine, Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001.

22. American Medical Association. Principles for pay-for-performance programs; 2005.

23. Rosenthal MB, Frank RG, Li Z, Epstein AM. From concept to practice: early experience with pay-for-performance. Journal of the American Medical Association October 12, 2005;294(14):1788-93.

24. Kahneman D, Tversky A. Prospect theory: an analysis of decision under risk. Econometrica 1979; 47(2):263-91.

25 Camerer CF. Prospect theory in the wild: evidence from the field. California Institute of Technology, Division of the Humanities and Social Sciences, Working Papers: No. 1037; 1998.

26. Oliver P. Rewards and punishments as selective incentives for collective action: theoretical investigations. American Journal of Sociology 1980;85(6):1356-1375.

27. Town R, Wholey DR, Kralewski J, Dowd B. Assessing the influence of incentives on physicians and medical groups. Medical Care Research and Review 2004;61(3 Suppl):80S-118S; discussion 119S-123S.

28. Werner R M, Alexander GC, Fagerlin A, Ubel PA. The "hassle factor": what motivates physicians to manipulate reimbursement rules? Archives of Internal Medicine 2002;162(10):1134-9.

29. Morreim E H. Gaming the system. Dodging the rules, ruling the dodgers. Archives of Internal Medicine 1991; 151(3):443-7.

30. Roland M. Linking 30% of UK GP’s pay to quality of care: a unique collaboration between funders, physicians and academics. Presentation to the Annual Meeting of AcademyHealth, Boston, MA, June 27, 2005.

31. Tieman J. Experimenting with quality. CMS-Premier initiative to reward best, punish worst. Modern Healthcare 2003; 33(28):6.

32. Rewarding superior quality care: the Premier Hospital Quality Incentive Demonstration. Centers for Medicare & Medicaid Services Fact Sheet.

33. Hickson GB, Altemeier WA, Perrin JM. Physician reimbursement by salary or fee-for-service: effect on physician practice behavior in a randomized prospective study. Pediatrics September 1987;80(3):344-50.

34. Roski J, Jeddeloh R, An L, et al. The impact of financial incentives and a patient registry on preventive care quality: increasing provider adherence to evidence-based smoking cessation practice guidelines. Preventive Medicine March 2003;36(3):291-99.

35 Zaslavsky AM, Hochheimer JN, Schneider EC, et al. Impact of sociodemographic case mix on the HEDIS measures of health plan quality. Medical Care October 2000;38(10):981-92.

36. Rosenthal MB, Fernandopulle R, Song HR, Landon B. Paying for quality: providers' incentives for quality improvement. Health Affairs 2004; 23 (2):127-41.

37. Berwick DM, Wald DL. Hospital leaders' opinions of the HCFA mortality data. Journal of the American Medical Association 1990;263(2):247-9.

38. Gupta N, Kotler PK, Dudley RA. A report card approach to ICUs. Journal of Intensive Care Medicine 2002; 17(5):211-8

39. Agency for Healthcare Research and Quality. AHRQ Quality Indicators—Guide to Patient Safety Indicators. Version 2.1, Revision 3. Rockville, MD: Agency for Healthcare Research and Quality; 2003, revised January 17, 2005. AHRQ Pub. No. 03-R203.

40. Agency for Healthcare Research and Quality. AHRQ Quality Indicators—Guide to Inpatient Quality Indicators: Quality of Care in Hospitals—Volume, Mortality, and Utilization. Revision 4. Rockville, MD: Agency for Healthcare Research and Quality; 2002, revised December 22, 2004.  AHRQ Pub. No. 02-RO204

41. Krumholz HM, Chen J, Wang Y, et al. Comparing AMI mortality among hospitals in patients 65 years of age and older: evaluating methods of risk adjustment. Circulation 1999;99(23):2986-92.

42. Tilley BC, Barnes AB, Bergstralh E, et al. A comparison of pregnancy history recall and medical records: Implications for retrospective studies. American Journal of Epidemiology 1985;121, 269-81.

43. Quam L, Ellis L, Venus P, et al. Using claims data for epidemiologic research: the concordance of claims-based criteria with the medical record and patient survey for identifying a hypertensive population. Medical Care 1993;31: 498-507.

44. Sirio CA, Shepardson LB, Rotondi AJ, et al. Community-wide assessment of intensive care outcomes using a physiologically based prognostic measure: implications for critical care delivery from Cleveland Health Quality Choice. Chest 1999; 115:793-801.

45 Burton TM. Operation that rated hospitals was success but the patience died. Wall Street Journal August 23, 1999:A1.

46. Clough JD, Engler D, Canuto PE. Cleveland Health Quality Choice was a failure, not a martyr. Quality & Safety in Health Care 2002 Dec;11(4):391.

47. Marshall M, Shekelle PG, Davies HTO, Smith PC. Public reporting on quality in the United States and the United Kingdom. Health Affairs (Millwood) May/June 2003; 22(3):134-48.

48. Marshall MN, Shekelle PG, Brook RH, Leatherman S. Use of performance data to change physician behavior. Journal of the American Medical Association September 6, 2000;284(9):1079.

49. Hibbard JH, Stockard J, Tusler M. Hospital performance reports: impact on quality, market share, and reputation. Health Affairs (Millwood) July-August 2005;24(4):1150-60.

50. Verdier J, Felt-Lisk S, Smieliauskas F, et al. Quality-Related Provider and Member Incentives in Medicaid Managed Care Organizations. Princeton, NJ: Center for Health Care Strategies; 2004.

51. Bridges to Excellence. GE, Ford, UPS, P&G, Verizon, others back new pay-for-quality initiative for physicians. Press release. April 10, 2003.

52. Nursing home pay-for-performance demonstration draft design. Slides from special open door forum on the nursing home pay-for-performance demonstration, September 20, 2005.

53. Burack JH, Impellizzeri P, Homel P, Cunningham JN Jr. Public reporting of surgical mortality: a survey of New York State cardiothoracic surgeons. Annals of Thoracic Surgery October 1999;68(4):1195-200.

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The authors gratefully acknowledge the valuable comments made by 10 public and private purchasers, who generously contributed their time and expertise in reviewing a formative draft.

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The views expressed in this report are those of the authors. No official endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services is intended or should be inferred.

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Copyright Notice

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AHRQ Publication No. 06-0047

Current as of April 2006
Internet Citation: Pay for Performance: A Decision Guide for Purchasers: References. April 2006. Agency for Healthcare Research and Quality, Rockville, MD.