Effect of hospital pay for performance on mortality in England.

Abstract

To the Editor: Sufficient money can almost certainly change clinicians' behavior. What we need to find out is what types of behavior are likely to change (and how much) and whether pay for performance is cost-effective. Kristensen et al. (Aug. 7 issue)1 conclude that results from “a pay-for-performance program in England were not maintained.” Eijkenaar2 and So and Wright3 found that improvements associated with pay for performance in health care are inconsistent and often small. In searching for an explanation, Kristensen et al. do not entertain the possibility that pay for performance in health care is ineffective. Research outside of . . .