Health Affairs, 25, no. 5 (2006): w412-w419 (Published online 5 September 2006) doi: 10.1377/hlthaff.25.w412 © 2006 by Project HOPE	New Online   VP Candidates On Health Reform   Cutler On McCain's Plan   Scoring Obama's Plan   Roundtable: Politics, Reform   Number Of Uninsured   Delivery System Overhaul

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Pay-For-Performance: Too Much Of A Good Thing? A Conversation With Martin Roland

As the United States moves down the road of pay-for-performance (P4P), concerns about unintended consequences are foremost in the minds of policymakers. Initial results from the world’s most ambitious P4P program, the United Kingdom’s Quality and Outcomes Framework (QOF), indicate that while quality improvements exceeded expectations, so too did the amount of funds paid out, straining the National Health Service (NHS) budget. Martin Roland, one of the leading U.K. health services researchers and an adviser to the QOF, gives his views on what went right and what went wrong, and he offers his advice to the United States about using financial incentives to improve quality.

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