Pay for Performance: Quality- and Value-Based Reimbursement

There is urgent need to reform health care reimbursement models, including physician compensation, to address high health care costs, despite numerous quality initiatives. Pay for performance (P4P) is a model that attempts to align financial incentives with better outcomes and value rather than the current system of rewarding volume and intensity of care delivered. P4P has been implemented in other countries besides the United States and is perhaps most advanced in the United Kingdom. Measurement for P4P is evolving, as are the types of incentives; neither is perfect at this time. For P4P to succeed, all health care stakeholders will need to collaborate.