Field of Work: Using financial incentives to improve the quality of health care.
Problem Synopsis: According to a 1999 report from the Institute of Medicine, preventable medical errors resulted in the death of an estimated 44,000 to 98,000 hospital patients a year. Americans were getting poor quality care, the wrong care or care that could hurt them. The IOM report urged that the health care payment system be redesigned to reward providers for implementing improvements in their care processes.
Synopsis of the Work: Rewarding Results: Aligning Incentives with High-Quality Health Care (January 2002 to March 2009), funded by the Robert Wood Johnson Foundation and the California HealthCare Foundation, tested the use of financial incentives to improve the quality of health care. The program supported seven projects across the nation that implemented systems designed to measure the performance of health care providers and adjust their compensation based on performance scores—a strategy commonly termed pay for performance.
The projects, their evaluations and related educational materials informed the health care sector about pay-for-performance designs and processes—those that were effective as well as those requiring refinement.
Six of the seven projects continued after program funding ended.
According to the national program office, the key lessons learned: