Performance payment challenges for family physician program

Area of Science:

• Health Services Management
• Healthcare Policy
• Primary Care Systems

Background:

• Payment mechanisms are vital for health system optimization.
• Pay for performance (P4P) incentivizes quality healthcare services.
• Implementing P4P within Iran's family physician program requires understanding its challenges.

Purpose of the Study:

• To investigate the challenges associated with implementing a P4P system in the family physician program.
• To identify barriers to the successful integration of P4P in primary care settings.

Main Methods:

• A qualitative study employing semi-structured interviews with 32 key informants.
• Purposeful sampling of participants with at least 5 years of experience in the family physician program.
• Framework analysis using MAXQDA 10 software for data analysis.

Main Results:

• Seven major themes of challenges were identified, including physician workload and training.
• Subthemes encompassed program promotion, team payment structures, and assessment/monitoring systems.
• Issues related to information management and the authority of family physicians were also highlighted.

Conclusions:

• Significant challenges hinder the successful implementation of P4P in the family physician program.
• Findings provide valuable insights for healthcare managers and policymakers.
• Addressing identified challenges is essential for optimizing P4P system effectiveness in primary care.