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Pay-for-performance programs in P4P programs Israeli sick funds.

Revital Gross¹, Asher Elhaynay, Nurit Friedman

¹Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Jerusalem, Israel. revital@jdc.org.il

Journal of Health Organization and Management

|May 21, 2008

Summary

Pay-for-performance (P4P) programs in Israel show successful implementation but raise concerns. Physicians worry P4P may shift focus from patient-centered care to measured clinical performance metrics.

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Area of Science:

Healthcare Management
Health Policy Analysis
Public Health Systems

Background:

Israel's healthcare system is dominated by two major sick funds covering 78% of the population.
Pay-for-performance (P4P) programs are increasingly adopted globally to incentivize quality healthcare.
Understanding the long-term implementation and outcomes of P4P is crucial for health system reform.

Purpose of the Study:

To analyze the development and evolution of P4P programs in Israel's largest sick funds.
To identify key features, outcomes, and concerns associated with P4P implementation.
To provide insights for other countries considering P4P initiatives.

Main Methods:

Longitudinal analysis of P4P program features and their changes over time.
Examination of reported outcomes and stakeholder concerns.
Case study approach focusing on Israel's national P4P experience.

Main Results:

P4P program implementation in Israel has been successful.
Concerns exist among managers and physicians regarding the impact of performance measurement.
Potential for P4P to narrow focus to measured areas and promote a statistical rather than patient-centered approach.

Conclusions:

Israel's P4P experience offers valuable lessons for nation-wide, long-term program implementation.
The study highlights facilitators of successful P4P adoption.
It also underscores critical issues related to P4P program outcomes and potential unintended consequences.