IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v24y2015i3p353-371.html
   My bibliography  Save this article

The Tougher the Better: An Economic Analysis of Increased Payment Thresholds on the Performance of General Practices

Author

Listed:
  • Yan Feng
  • Ada Ma
  • Shelley Farrar
  • Matt Sutton

Abstract

We investigate whether and how a change in performance‐related payment motivated General Practitioners (GPs) in Scotland. We evaluate the effect of increases in the performance thresholds required for maximum payment under the Quality and Outcomes Framework in April 2006. A difference‐in‐differences estimator with fixed effects was employed to examine the number of patients treated under clinical indicators whose payment schedules were revised and to compare these with the figures for those indicators whose schedules remained unchanged. The results suggest that the increase in the maximum performance thresholds increased GPs' performance by 1.77% on average. Low‐performing GPs improved significantly more (13.22%) than their high‐performing counterparts (0.24%). Changes to maximum performance thresholds are differentially effective in incentivising GPs and could be used further to raise GPs' performance across all indicators. Copyright © 2013 John Wiley & Sons, Ltd.

Suggested Citation

  • Yan Feng & Ada Ma & Shelley Farrar & Matt Sutton, 2015. "The Tougher the Better: An Economic Analysis of Increased Payment Thresholds on the Performance of General Practices," Health Economics, John Wiley & Sons, Ltd., vol. 24(3), pages 353-371, March.
    • Handle: RePEc:wly:hlthec:v:24:y:2015:i:3:p:353-371
    DOI: 10.1002/hec.3022
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3022
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.3022?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Matt Sutton & Ross Elder & Bruce Guthrie & Graham Watt, 2010. "Record rewards: the effects of targeted quality incentives on the recording of risk factors by primary care providers," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 1-13, January.
    2. Stephen Morris & Rosalind Goudie & Matt Sutton & Hugh Gravelle & Robert Elliott & Arne Risa Hole & Ada Ma & Bonnie Sibbald & Diane Skåtun, 2011. "Determinants of general practitioners' wages in England," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 147-160, February.
    3. Dusheiko, Mark & Gravelle, Hugh & Martin, Stephen & Rice, Nigel & Smith, Peter C., 2011. "Does better disease management in primary care reduce hospital costs? Evidence from English primary care," Journal of Health Economics, Elsevier, vol. 30(5), pages 919-932.
    4. Heckman, James J. & Lalonde, Robert J. & Smith, Jeffrey A., 1999. "The economics and econometrics of active labor market programs," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 31, pages 1865-2097, Elsevier.
    5. Hugh Gravelle & Matt Sutton & Ada Ma, 2010. "Doctor Behaviour under a Pay for Performance Contract: Treating, Cheating and Case Finding?," Economic Journal, Royal Economic Society, vol. 120(542), pages 129-156, February.
    6. Bryan Dowd & Roger Feldman & WILLIAM Nersesian, 2013. "Setting Pay For Performance Targets: Do Poor Performers Give Up?," Health Economics, John Wiley & Sons, Ltd., vol. 22(2), pages 168-179, February.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Oxholm, Anne Sophie & Kristensen, Søren Rud & Sutton, Matt, 2018. "Uncertainty about the effort–performance relationship in threshold-based payment schemes," Journal of Health Economics, Elsevier, vol. 62(C), pages 69-83.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Fiorentini, Gianluca & Lippi Bruni, Matteo & Ugolini, Cristina, 2013. "GPs and hospital expenditures. Should we keep expenditure containment programs alive?," Social Science & Medicine, Elsevier, vol. 82(C), pages 10-20.
    2. Iezzi, Elisa & Lippi Bruni, Matteo & Ugolini, Cristina, 2014. "The role of GP's compensation schemes in diabetes care: Evidence from panel data," Journal of Health Economics, Elsevier, vol. 34(C), pages 104-120.
    3. Ammi, Mehdi & Fortier, Grant, 2017. "The influence of welfare systems on pay-for-performance programs for general practitioners: A critical review," Social Science & Medicine, Elsevier, vol. 178(C), pages 157-166.
    4. Oxholm, Anne Sophie & Kristensen, Søren Rud & Sutton, Matt, 2018. "Uncertainty about the effort–performance relationship in threshold-based payment schemes," Journal of Health Economics, Elsevier, vol. 62(C), pages 69-83.
    5. Godager , Geir & Scott, Anthony, 2023. "Physician Behavior and Health Outcomes," HERO Online Working Paper Series 2023:3, University of Oslo, Health Economics Research Programme.
    6. Allen, Thomas & Whittaker, William & Sutton, Matt, 2017. "Does the proportion of pay linked to performance affect the job satisfaction of general practitioners?," Social Science & Medicine, Elsevier, vol. 173(C), pages 9-17.
    7. Fichera, Eleonora & Gray, Ewan & Sutton, Matt, 2016. "How do individuals’ health behaviours respond to an increase in the supply of health care? Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 159(C), pages 170-179.
    8. Tor Iversen & Hilde Lurås, 2012. "Capitation and Incentives in Primary Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 26, Edward Elgar Publishing.
    9. Mark Dusheiko & Hugh Gravelle & Stephen Martin & Nigel Rice & Peter C Smith, 2011. "Does Better Disease Management in Primary Care Reduce Hospital Costs?," Working Papers 065cherp, Centre for Health Economics, University of York.
    10. Emma McManus & Jack Elliott & Rachel Meacock & Paul Wilson & Judith Gellatly & Matt Sutton, 2021. "The effects of structure, process and outcome incentives on primary care referrals to a national prevention programme," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1393-1416, June.
    11. Fichera, Eleonora & Banks, James & Siciliani, Luigi & Sutton, Matt, 2018. "Does patient health behaviour respond to doctor effort?," Journal of Economic Behavior & Organization, Elsevier, vol. 156(C), pages 225-251.
    12. Andrea Pufahl & Christoph R. Weiss, 2009. "Evaluating the effects of farm programmes: results from propensity score matching," European Review of Agricultural Economics, Oxford University Press and the European Agricultural and Applied Economics Publications Foundation, vol. 36(1), pages 79-101, March.
    13. Gautier, Pieter & van Vuuren, Aico & Siegmann, Arjen, 2007. "The Effect of the Theo van Gogh Murder on House Prices in Amsterdam," CEPR Discussion Papers 6175, C.E.P.R. Discussion Papers.
    14. James J. Heckman, 1991. "Randomization and Social Policy Evaluation Revisited," NBER Technical Working Papers 0107, National Bureau of Economic Research, Inc.
    15. Belot, Michèle & James, Jonathan, 2014. "A new perspective on the issue of selection bias in randomized controlled field experiments," Economics Letters, Elsevier, vol. 124(3), pages 326-328.
    16. Nicola Pavoni & G. L. Violante, 2007. "Optimal Welfare-to-Work Programs," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 74(1), pages 283-318.
    17. Michael Lechner & Ruth Miquel & Conny Wunsch, 2011. "Long‐Run Effects Of Public Sector Sponsored Training In West Germany," Journal of the European Economic Association, European Economic Association, vol. 9(4), pages 742-784, August.
    18. Victor Chernozhukov & Iván Fernández‐Val & Blaise Melly, 2013. "Inference on Counterfactual Distributions," Econometrica, Econometric Society, vol. 81(6), pages 2205-2268, November.
    19. Barbara Sianesi, 2002. "Swedish active labour market programmes in the 1990s: overall effectiveness and differential performance," IFS Working Papers W02/03, Institute for Fiscal Studies.
    20. Bronwyn Hall & Alessandro Maffioli, 2008. "Evaluating the impact of technology development funds in emerging economies: evidence from Latin America," The European Journal of Development Research, Taylor and Francis Journals, vol. 20(2), pages 172-198.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:24:y:2015:i:3:p:353-371. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.