Issues in pay for performance: the case of diabetes self-management

Pay for performance is a concept recently on the agenda of many health care providers, administrators, insurers, and payors in their search for methods to provide the best care at the most efficient price. At the same time it promises to promote quality care by paying financial incentives to providers who perform well clinically. As the fields continue to debate this approach, the following article explores how the pay-for-performance concept may be applied to one of the most prevalent chronic illnesses: diabetes. It identifies some of the issues and problems that may be faced with diseases such as diabetes, in which outcomes rely greatly on the role of the patient in self-management. Such considerations must be taken into account in the event of the refinement and implementation of pay for performance.