Pay for performance metrics do not show benefit to patients

Pay-for-performance targets set for general practitioners in the United Kingdom are failing to improve the health of patients with high blood pressure, according to a study in the British Medical Journal.

The UK pay for performance incentive (the Quality and Outcomes Framework), was implemented in April 2004 and included specific targets for general practitioners to show high quality care for patients with hypertension and other diseases. For the study, researchers examined medical records of patients with hypertension in the UK, comparing data from before and after the pay for performance incentive was introduced.

Researchers found that pay for performance had no discernible effects on processes of care or on hypertension-related clinical outcomes, and conclude that the system may not be sufficient to improve quality of care and outcomes for hypertension and other common chronic conditions.

(Sources: Quality Digest,, February 3, 2011; British Medical Journal,, January 25, 2011)