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Quality-Based Payment: Six Case Examples

The logic of paying more for high-quality care and less for low-quality resonates. Increasingly health system leaders worldwide acknowledge that payment reforms are needed to do just that, prompted no doubt by the growing body of evidence indicating that quality is not what it should be. This review was undertaken to explore contexts in which quality-based […]
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Does Pay-for-Performance Benefit Patients With Multiple Chronic Conditions? Evidence from a Universal Coverage Health Care System

This study examines the effects of pay-for-performance mechanisms on health care provision, quality of care over time (continuity of care) and health care outcomes.  The research includes patients with diabetes who have been enrolled in a pay-for-performance program since 2005 as a part of the compulsory universal health insurance program in Taiwan.
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Pay-for-performance in resource-constrained settings: Lessons learned from Thailand’s Quality and Outcomes Framework

In 2010, Thailand introduced the first pay-for-performance (P4P) programme, called on-top payment, in order to reduce variations in quality and accessibility of care provision by encouraging CUPs to improve infrastructure and staffing. Since this programme was criticised for not clearly contributing to the quality of services and health outcomes, it was replaced by the Quality and Outcomes Framework (QOF) in October […]
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Can We Expect Results-Based Financing to Improve Quality of Care?

Results-Based Financing (RBF) schemes in healthcare are premised on the notion that “paying for results” rather than for inputs is more likely to improve performance. But getting from that attractive hypothesis to program efforts that improve quality of care and outcomes at population scale—in the real world—is far from simple. The article offers an overview […]
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Coming Full Circle: How Health Worker Motivation and Performance in Results-Based Financing Arrangements Hinges on Strong and Adaptive Health Systems

This paper presents findings from a study which sought to understand why health workers in the results-based financing (RBF) arrangements in Zimbabwe reported being satisfied with the improvements in working conditions and compensation, but paradoxically reported lower motivation levels compared to those not working under RBF arrangements.
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Learning Lessons on Implementing Performance-Based Financing, from a Multi-Country Evaluation

This synthesis report explores the lessons learned on design, implementation and effects of financial incentives in the form of Performance Based Financing (PBF) in the health sector, as supported in Sub–Saharan Africa by the two Dutch NGO’s Cordaid and HealthNet TPO. Towards this aim a multi-country study was undertaken in 2008, led by the Royal […]
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