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Paying for performance in primary medical care: learning about and learning from "success" and "failure" in England
Ruth McDonald1, Joseph White, Theodore R Marmor
1University of Manchester.
Abstract:
Paying physicians to hit performance targets is becoming increasingly fashionable, as evidenced by the growing number of "pay-for-performance" programs in the United States and beyond. This article compares pay-for-performance initiatives in two nations--the United Kingdom and the United States. It pays particular attention to the context in which the initiatives were conceived and implemented, factors which are largely neglected in the pay-for-performance literature. Despite some glowing reviews of the UK national pay-for-performance program for primary care doctors, we suggest that such programs face significant technical obstacles in all cases and particularly severe institutional obstacles in the United States.
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