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Does Pay-for-Performance Steal From the Poor and Give to the Rich?

Rachel M. Werner, MD, PhD
[+] Article, Author, and Disclosure Information

From Philadelphia Veterans Affairs Medical Center and University of Pennsylvania, Philadelphia, PA 19104.

Disclaimer: The contents of this article do not represent the views of the U.S. Department of Veterans Affairs or the U.S. government.

Acknowledgment: The author thanks David Asch, MD, for helpful comments on an earlier draft of this manuscript.

Grant Support: By a U.S. Department of Veterans Affairs Health Services Research and Development Service Career Development Award.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1688.

Requests for Single Reprints: Rachel Werner, MD, PhD, University of Pennsylvania, 1230 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104; e-mail, rwerner@upenn.edu.

Ann Intern Med. 2010;153(5):340-341. doi:10.7326/0003-4819-153-5-201009070-00010
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Historically, most health care payment systems have paid providers on the basis of the quantity or intensity of the services they provide. In contrast, pay-for-performance ties a portion of payment to quality of care by paying more to providers whose care meets specified standards. By doing so, pay-for-performance shifts the emphasis of health care delivery from the quantity to the quality of care. Because the principle of realigning payment to improve quality of care is difficult to dispute, many pay-for-performance programs have recently been implemented in health care.

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