• Project Profiles
  • NICU Feeding Practices
  • Approaches to Public Health Nursing
  • HKN Gap Analysis
  • Evidence Literacy Project
  • Assessing Patient Complexity
  • Early Identification of Autism
  • Measuring Quality Care
  • Young Adults in Long-Term Care
  • Reducing Medication Errors
  • Making Exercise Sticky
  • Stroke Guidelines
  • Driving Change in Mental Health
  • Help for New Mothers
  • Mentoring Makes a Difference
  • Pay-for-Performance
  • Good Care is About People
  • Working Better Together
  • Health Technology Assessment
  • Looking at the Link between Pain and Aggression
  • Reviewing Determinants of Health
  • End of Life Care Decisions in Focus
  • Rural Health Service Delivery
  • Looking at Organizational Problems
  • Integrating Evaluation with Planning
  • Rural Health Needs
  • Suicide Prevention
  • Student Health
  • Hepatitis A Immunity Project
• Participant Profiles
• Knowledge Infostructure
• Celebrating the Legacy

Pay-for-Performance in the Spotlight

A growing body of research evidence indicates that family physicians should spend more time on managing patients who suffer with chronic diseases. But physicians are not rewarded for extra time spent with patients under the current fee-for-service model. Pay-for-performance is an alternative model that may offer a solution. It provides reimbursement based on financial incentives to physicians for attaining certain quality benchmarks established by the payers. In Alberta, a provincial working group is developing performance measures and indicators.

As Regional Primary Care Coordinator with Alberta Health Services in Grande Prairie, Yong Shi was interested in the impact pay-for-performance may have on quality of care in office-based chronic disease care.

For his SEARCH VI local project, he reviewed six cohort studies of pay-for-performance programs. He found that financial incentives have a positive effect on improving achievement/adherence to quality standards or clinical practice guidelines. His research also highlighted issues that should be taken into account when designing and implementing pay-for-performance programs. "My hope is that these findings may be useful in the implementation of a similar program in Alberta's primary care settings."

On a personal note, Shi says that SEARCH widened his perspective on research. "From my education and work experience, I have mainly dealt with quantitative research. SEARCH gave me the opportunity to gain knowledge and develop skills with qualitative research. The program also opened my mind to using the evidence base in my work, even though I do not work in the clinical environment. It's clear that the evidence base can be very useful in services planning and budgeting. This experience has been very valuable professionally."