Pay for Performance in Primary Care: Proceed with Caution, Pitfalls Ahead

Abstract

Pay for performance in healthcare - the concept that payment should reflect processes and outcomes of care - has generated growing interest, debate and action among policy makers, health system managers and healthcare providers in Canada and internationally. With the introduction of its Quality and Outcomes Framework (QOF) for primary care in 2004, the United Kingdom raised pay for performance to a new level in both scale and scope (Roland 2004; Roland et al. 2006)