Pay for Quality
Pay for Quality
Pay for Quality
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164 <strong>Pay</strong> <strong>for</strong> <strong>Quality</strong> KCE Reports 118<br />
Both experts and Belgian stakeholders believe that it is important that government and<br />
clinical leadership recognize that quality is variable and improvement is important. For a<br />
P4Q programme to be successful a cultural shift towards this recognition is needed.<br />
P4Q programmes should thereby be seen as part of a range of quality improvement<br />
activities and not as stand-alone initiatives. Finally it must be stressed out that <strong>for</strong> a P4Q<br />
programme to work, it is necessary to take into account the lessons learned from past<br />
P4Q programmes.<br />
Future research on <strong>Pay</strong> <strong>for</strong> <strong>Quality</strong> should focus on the effects of P4Q on currently less<br />
in<strong>for</strong>med domains such as continuity of care, patient and provider experience, and cost<br />
effectiveness of program use, as compared to the use of existing implicit financial<br />
incentives. To date potential issues in regard to intrinsic motivation effects have been<br />
largely neglected in current healthcare research and need specific attention in future<br />
studies, making use of survey and qualitative methods. Knowledge from economics,<br />
psychology and social sciences can be leveraged further to refine P4Q design<br />
recommendations. The international comparison of P4Q within different health systems<br />
should be broadened to include a wider implicit incentive scope and to provide explicit<br />
attention to the use of incentives in developing countries. Within the context of the<br />
Belgian healthcare system, if policy makers decide to refocus incentives toward quality<br />
of care, research should shift from an exploratory to a pilot testing phase, making use of<br />
demonstration projects.