Speed Reads

Evidence-based medicine

The disappointing results of pay-for-performance medicine

One of the biggest complaints about the American healthcare system is how payments are mostly structured as fee-for-service — meaning that patients are charged for each test, operation, visit, etc., they receive. There are good reasons to think that leads to overtreatment, giving patients care they don't need (and may even harm them) in order to get more money.

This has led many hospitals and medical organizations to try out a "pay-for-performance" structure. The idea here is just as you'd expect: paying doctors when they achieve a good outcome for their patients, instead of just for each procedure performed. Aaron Carroll digs into the research below, and it turns out the results are not very impressive:

Carroll doesn't go into this that much, but other research shows that financial motivators can actually impede creative thinking. Worth remembering as we continue to think about ways to improve our healthcare policy.