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Implementing hospital pay-for-performance: Lessons learned from the French pilot program

Author

Listed:
  • Anne Girault

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, EHESP - École des Hautes Études en Santé Publique [EHESP])

  • Martine Bellanger

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, EHESP - École des Hautes Études en Santé Publique [EHESP])

  • Benoît Lalloué

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, EHESP - École des Hautes Études en Santé Publique [EHESP])

  • Philippe Loirat

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité)

  • Jean-Claude Moisdon

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, CGS i3 - Centre de Gestion Scientifique i3 - Mines Paris - PSL (École nationale supérieure des mines de Paris) - PSL - Université Paris Sciences et Lettres - I3 - Institut interdisciplinaire de l’innovation - CNRS - Centre National de la Recherche Scientifique)

  • Etienne Minvielle

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, EHESP - École des Hautes Études en Santé Publique [EHESP])

Abstract

Despite a wide implementation of pay-for-performance (P4P) programs, evidence on their impact in hospitals is still limited. Our objective was to assess the implementation of the French P4P pilot program (IFAQ1) across 222 hospitals. The study consisted of a questionnaire among four leaders in each enrolled hospital, combined with a qualitative analysis based on 33 semi-structured interviews conducted with staff in four participating hospitals. For the questionnaire results, descriptive statistics were performed and responses were analyzed by job title. For the interviews, transcripts were analysed using coding techniques. Survey results showed that leaders were mostly positive about the program and reported a good level of awareness, in contrast to the frontline staff, who remained mostly unaware of the program's existence. The main barriers were attributed to lack of clarity in program rules, and to time constraints. Different strategies were then suggested by leaders. The qualitative results added further explanations for low program adoption among hospital staff, so far. Ultimately, although paying for quality is still an intuitive approach; gaps in program awareness within enrolled hospitals may pose an important challenge to P4P efficacy. Implementation evaluations are therefore necessary for policymakers to better understand P4P adoption processes among hospitals.

Suggested Citation

  • Anne Girault & Martine Bellanger & Benoît Lalloué & Philippe Loirat & Jean-Claude Moisdon & Etienne Minvielle, 2017. "Implementing hospital pay-for-performance: Lessons learned from the French pilot program," Post-Print hal-01464478, HAL.
    • Handle: RePEc:hal:journl:hal-01464478
    DOI: 10.1016/j.healthpol.2017.01.007
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    Citations

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    Cited by:

    1. Field, Robert I. & Keller, Catherine & Louazel, Michel, 2020. "Can governments push providers to collaborate? A comparison of hospital network reforms in France and the United States," Health Policy, Elsevier, vol. 124(10), pages 1100-1107.
    2. Minvielle, E. & Fierobe, A. & Fourcade, A. & Ferrua, M. & di Palma, M. & Scotté, F. & Mir, O., 2023. "The use of patient-reported outcome and experience measures for health policy purposes: A scoping review in oncology," Health Policy, Elsevier, vol. 129(C).
    3. Slawomirski, Luke & Hensher, Martin & Campbell, Julie & deGraaff, Barbara, 2024. "Pay-for-performance and patient safety in acute care: A systematic review," Health Policy, Elsevier, vol. 143(C).

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