Pay-for-performance dealt a major blow

A FAILED UK general practice incentive scheme for hypertension management has added weight to arguments against the introduction of pay-for-performance models in Australia, experts say.

Evaluation of a £1.8 billion ($2.9 billion) scheme involving nearly 480,000 patients with hypertension showed the incentives had “no discernible effect” on management or outcomes over three years. 

Substantial financial incentives – up to a quarter of a GP’s total income – did not improve blood pressure monitoring and control, or rates of stroke, myocardial infarction, renal failure, heart failure or all-cause mortality in the 358 general practices, the study found. 

The authors said the scheme may have been ineffective because some performance thresholds may be too low for the financial incentives to be effective. 

Alistair Vickery, professor of general practice at the University of Western Australia, said

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