The tougher the better: An economic analysis of increased payment thresholds on the performance of general practices

Yan Feng, Ada Ma, Shelley Farrar, Matt Sutton

    Research output: Contribution to journalArticlepeer-review

    Abstract

    We investigate whether and how a change in performance-related payment motivated General Practitioners (GPs) in Scotland. We evaluate the effect of increases in the performance thresholds required for maximum payment under the Quality and Outcomes Framework in April 2006. A difference-in-differences estimator with fixed effects was employed to examine the number of patients treated under clinical indicators whose payment schedules were revised and to compare these with the figures for those indicators whose schedules remained unchanged. The results suggest that the increase in the maximum performance thresholds increased GPs' performance by 1.77% on average. Low-performing GPs improved significantly more (13.22%) than their high-performing counterparts (0.24%). Changes to maximum performance thresholds are differentially effective in incentivising GPs and could be used further to raise GPs' performance across all indicators. © 2013 John Wiley & Sons, Ltd.
    Original languageEnglish
    Pages (from-to)353-371
    JournalHealth Economics
    Volume24
    Issue number3
    DOIs
    Publication statusPublished - 2015

    Keywords

    • Financial incentives
    • General practitioners
    • Quality and outcomes framework

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