Study: California P4P program has not led to ‘breakthrough’ QI

Although pay-for-performance (P4P) programs have spurred physician groups to make practice changes and alter compensation methods, the investments have not yet translated into substantial quality gains, according to a study published in the March/April issue of Health Affairs.


According to Health Affairs, physician organizations involved in the California Integrated Healthcare Association’s (IHA) P4P program reported having increased physician-level performance feedback and accountability, speeded up information technology adoption, and sharpened their organizational focus and support for improvement in response to P4P; however, after three years of investment, these changes had not translated into breakthrough quality improvements.


(Sources: The Advisory Board Daily Briefing,, March 10, 2009; Journal of Health Affairs,, accessed March 12, 2009)