Impact of a pay-for-performance incentive on support for smoking cessation and on smoking prevalence among people with diabetes

Impact of the GP contract on inequalities associated with influenza immunisation: a retrospective population-database analysis

“…32 Further, Millet et al found that the proportion of patients with diabetes with documented smokingcessation advice increased dramatically (from 48% in 2003 to 83.5% in 2005), and that the prevalence of smoking had decreased significantly among all socioeconomic groups in the first year of implementation of the QOF. 33 The findings of this study are, therefore, consistent with other patient-level analyses, showing that socioeconomic inequalities are persistent for some (but not all) important indicators of quality. As such, ecological or composite indicator analyses showing reducing socioeconomic inequalities should be confirmed by patientlevel analyses and careful examination of individual indicators.…”

Pay for performance: learning about quality

“…[7][8][9][10] Although as a father and son we have not previously written a paper together, we have exchanged many stories about our successes and failures and those of our peers, an advantageous and ongoing learning opportunity that we both have enjoyed. We therefore offer advice for both students (summarized in Box 1) and mentors (Box 2).…”

“…In this issue of CMAJ (page 1705), Millett and colleagues 7 report on their study of 2 facets of pay-for-performance incentives: whether financial incentives improve process-ofcare measures and whether financial incentives improve patient outcomes. Using a study population of patients with diabetes in 32 participating primary care practices in southwest London, England, the authors examined the impact of pay-for-performance incentives introduced in 2004 on the documentation of smoking status and on the delivery of smoking cessation advice.…”

Sustainability of Quality Improvement Following Removal of Pay-for-Performance Incentives

“…[1][2][3] Of particular note, the Patient Protection and Affordable Care Act (ACA) mandates the adoption of P4P (i.e., value-based purchasing) for hospitals and physicians participating in the Medicare program. Although P4P programs vary markedly in their design, two common features are: 1) defined performance goals for selected quality measures, and 2) associated financial incentives that can be targeted to institutions, individuals or both.…”