Effects of pay for performance on motivation and professional engagement in Primary Health Care

Abstract

Pay-for-performance has been used as a strategy to encourage improved health outcomes. This qualitative study analyzed the effects of this strategy on the motivation and engagement of the professionals involved. Focus groups, analyzed using content analysis, revealed mixed effects: while some reported recognition, professional appreciation, and enthusiasm for achieving goals, others pointed to perceptions of unfairness, embarrassment, and inappropriate behaviors. It is therefore highlighted that the success of performance-based pay programs depends on careful planning, transparency, effective communication, and active participation of professionals, to transform financial incentives into genuine engagement and improved services.