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A conceptual framework for evaluation of community pharmacy pay-for-performance programs.

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    Financial incentives in pay-for-performance (P4P) programs can improve community pharmacy quality. This study proposes a framework integrating economic, psychological, and organizational theories to understand P4P impacts on pharmacies.

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    Area of Science:

    • Health Services Research
    • Pharmacy Practice
    • Health Economics

    Background:

    • Pay-for-performance (P4P) programs are increasingly used to incentivize healthcare quality and efficiency.
    • Existing P4P evaluations have not specifically focused on community pharmacy settings.
    • Understanding the impact of financial incentives in community pharmacies is crucial for program design.

    Purpose of the Study:

    • To develop a theory-derived conceptual framework for understanding how financial incentives influence community pharmacy performance.
    • To integrate economic, psychological, and organizational theories into a novel P4P model for pharmacies.

    Main Methods:

    • A comprehensive literature review of agency theory, motivation theories, and organizational theory was conducted.
    • Previous healthcare P4P models were reviewed and expanded upon.
    • A conceptual framework was developed based on integrated theoretical components.

    Main Results:

    • A conceptual framework was derived with four key domains: incentive, pharmacy characteristics, external influencing factors, and P4P program measures.
    • Hypothesized relationships between these domains were identified, illustrating potential pathways of influence.
    • The framework highlights the importance of psychological and organizational factors beyond financial incentives.

    Conclusions:

    • The proposed framework illustrates how P4P integration, alongside other factors, can impact the pharmacy environment and performance on quality measures.
    • This model provides a foundation for future research investigating community pharmacy performance in P4P programs.
    • It supports the advancement of pharmacists' roles in patient care and evolving reimbursement models.