Evaluation of a Pay for Performance Scheme in Maternity Care: The Commissioning Quality and Innovation Payment Framework in England

Pay for performance schemes (P4P) have been considered by many governments and implemented (for example in the UK and the US) for many years. The English health care system is an example of this: it has recently experienced a wide range of policy interventions which pay providers of health care for quality with the aim of improving the quality of care delivered to the population. Commissioning Quality and Innovation Payment Framework started in 2009/10 with the aim to improve quality of care provided by NHS Trusts. This study examines the impact of the introduction of the Commissioning Quality and Innovation Payment framework (CQUIN) on elective and emergency c-section rates in England for the 2010/11 CQUIN taxonomy. I show that the CQUIN scheme does not have any statistically significant impact on c-section rates.