Would German physicians opt for pay-for-performance programs? A willingness-to-accept experiment in a large general...

Area of Science:

• Health Services Research
• Healthcare Management

Background:

• Pay-for-performance (P4P) programs are challenging to implement effectively.
• Previous studies indicate P4P often fails to improve healthcare quality.
• Gaining healthcare provider acceptance is critical for P4P success.

Purpose of the Study:

• To determine German general practitioners' (GPs) willingness to participate in P4P.
• To identify the bonus rates influencing GP participation.
• To compare participants and non-participants regarding attitudes and characteristics.

Main Methods:

• A mail survey was distributed to 2493 general practitioners in Lower Saxony.
• The response rate was 36.2%.
• The survey assessed attitudes toward P4P and willingness to experiment with its implementation.

Main Results:

• GP participation increased from 28% at a 2.5% bonus to 50% at a 20% bonus.
• Participants demonstrated better target achievement and anticipated higher P4P gains.
• Key differences emerged in perceptions of P4P feasibility, incentives, and unintended consequences, with fairness being a crucial factor.

Conclusions:

• Enhanced evidence of P4P effectiveness is needed to encourage GP participation.
• Tailoring P4P programs to address GP concerns is essential for future initiatives.
• Effective communication and thorough discussion with healthcare providers are vital for successful program implementation.