Pay for Quality

KCE Reports 118 Pay for Quality 31
3.4 P4Q PRINCIPLES FOR DESIGN AND IMPLEMENTATION
In this section, a multifactorial implementation framework (see Figure 2) is proposed
that can be applied by designers of a new P4Q programme. The ‘MIMIQ’ model (Model
for Implementing and Monitoring Incentives for Quality), which can also be interpreted
as a checklist, is generally applicable, and contains different items which are not
necessarily to be considered as mandatory elements of a P4Q programme, but rather as
aspects to keep in mind and to challenge when designing a programme.
The framework is in our view comprehensive and complementary to previously
published models/checklists. For instance, Dudley and Rosenthal (2006) published a
checklist focussing on the content of P4Q programmes 78 .
They distinguished 4 phases, thereby setting the basis for a time dimension in the design
and implementation of P4Q: the contemplation phase, the design, the implementation
and the evaluation. Based on other conceptual models identified in our review, we build
further on this phased approach in our checklist. Figure shows how we made a
distinction between questions related to the context and actors (health care system,
payers, providers, patients) on the one hand and the programme on the other hand.
Finally, the interplay between both creates the full P4Q picture.
Later in this report we will come back to this model on different occasions, since based
on the existing evidence of what works and what doesn’t (chapter 4) it will become
more clear to which extent the different elements of the model need to be complied
with in order to increase the chances for a successful programme.