Interesting article, published in the New England Journal of Medicine, that looked at the impact on quality of care in the U.K after the removal of incentives from existing pay-for-performance schemes. The authors conducted interrupted time-series analyses of electronic medical record (EMR) data from 2010 to 2017 for 12 quality-of-care indicators in the United Kingdom’s Quality and Outcomes Framework for which financial incentives were removed in 2014 and 6 indicators for which incentives were maintained. They estimated the effects of removing incentives on changes in performance on quality-of-care measures. They found the removal of financial incentives was associated with an immediate decline in performance on quality measures. In part, the decline probably reflected changes in EMR documentation, but declines on measures involving laboratory testing suggest that incentive removal also changed the care delivered.
- Quality of Care in the United Kingdom after Removal of Financial Incentives. New England Journal of Medicine. September 6, 2018