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Key Indicators of Performance-Based Payment to Physicians by Insurance Organizations in Iran
Zeinolabedin Abbasi Nowdeh1,2, Khadije Safizade1, Seyede Fateme Mousavi Jam1
1Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Medical Journal of the Islamic Republic of Iran
|July 28, 2026
Summary
This study identified 18 key performance indicators for physician payments in Iran, focusing on quality and efficiency. These indicators aim to motivate healthcare providers and improve patient care through transparent compensation linked to measurable outcomes.
Area of Science:
- Health Economics
- Healthcare Management
- Medical Policy
Background:
- Fair payment systems significantly impact healthcare workforce motivation and work quality.
- Performance-based payment initiatives link compensation to measurable outcomes to enhance this relationship.
- Physician payment systems in Iran require identification of key performance indicators for improved transparency and motivation.
Purpose of the Study:
- To identify key indicators for performance-based payment systems for physicians in Iran.
- To inform the development of transparent and effective physician compensation models.
Main Methods:
- A mixed-method approach combining a scoping review (2000-2024, Persian and English databases) and semi-structured interviews.
- Scoping review followed the Arksey and O'Malley framework.
- Thematic analysis of interview data using MAXQDA software, with a prioritization matrix for indicator selection.
Main Results:
- Eighteen key performance indicators were identified through comprehensive review and analysis.
- Key indicators include prescribing expensive diagnoses/procedures, adherence to clinical guidelines, services provided per physician, and electronic service delivery compliance (e.g., PMR, e-prescriptions).
Conclusions:
- Key performance indicators and managerial dashboards are vital for enhancing efficiency, equity, and quality in healthcare.
- Utilizing these indicators can motivate providers to prioritize quality and responsiveness.
- Effective use by purchasing and insurance organizations aids in managing healthcare costs.
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