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Patient Opinions Regarding ‘Pay for Performance for Patients’

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Abstract

Background

Pay for performance (P4P) programs have shown only modest improvements in outcomes and do not target patient behaviors. Many large employers and payers are turning to pay for performance for patients (P4P4P) to reduce health costs and improve the health of their covered populations. How these programs may be perceived by patients is unknown.

Objective

To assess patients’ opinion of the acceptability of P4P4P.

Design

Cross-sectional self-administered survey.

Participants

Patients in waiting rooms in two university-based primary care clinics.

Measurements

Participants were asked their opinions about paying people to quit smoking, lose weight, control their blood pressure, or control their diabetes.

Results

Respondents were split on whether P4P4P is desirable. Thrity-six to 42% thought it was a good/excellent idea to pay smokers to quit smoking, obese people to lose weight, people with hypertension to control their blood pressure, or people with diabetes to control their blood sugar, while 41–44% of the sample thought it was a bad/very bad idea. Smokers and patients who were obese endorsed P4P4P more favorably as a means to achieving tobacco cessation and weight loss than their non-smoking and non-obese counterparts.

Conclusions

Acceptance of paying patients for performance by the general population is equivocal. Establishing the efficacy of paying patients for performance may help it gain wider acceptance.

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Acknowledgements

The work in this paper was supported by a grant from the Commonwealth of Pennsylvania, titled Collaboration to Reduce Disparities in Hypertension, grant no. ME-02-382.

The Commonwealth bears no responsibility for the content of this article. This paper was presented as a poster at the Society of General Internal Medicine 2007 National Meeting in Toronto, Canada, 2007.

Conflict of Interest

Drs. Long and Helweg-Larsen have no conflicts of interest in relationship to this work. Dr. Volpp received an honorarium from Astra Zeneca for convening a conference on medication adherence as well as receiving investigator initiated grant support from Pfizer for ongoing patient follow-up for a randomized controlled trial of copayment reductions that was initiated through the grant that also supported this work (the Commonwealth of Pennsylvania sponsored Collaboration to Reduce Disparities in Hypertension, grant no. ME-02-382).

Author information

Authors and Affiliations

  1. Philadelphia VA Center for Health Equity Research and Promotion, Philadelphia, PA, USA

    Judith A. Long MD & Kevin G. Volpp MD, PhD

  2. University of Pennsylvania School of Medicine, Philadelphia, PA, USA

    Judith A. Long MD & Kevin G. Volpp MD, PhD

  3. University of Pennsylvania Leonard Davis Institute for Health Economics, Philadelphia, PA, USA

    Judith A. Long MD & Kevin G. Volpp MD, PhD

  4. Dickinson College, Calisle, PA, USA

    Marie Helweg-Larsen PhD

  5. Department of Health Care Systems, the Wharton School, Philadelphia, PA, USA

    Kevin G. Volpp MD, PhD

Authors
  1. Judith A. Long MD
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  2. Marie Helweg-Larsen PhD
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  3. Kevin G. Volpp MD, PhD
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Correspondence to Judith A. Long MD.

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Long, J.A., Helweg-Larsen, M. & Volpp, K.G. Patient Opinions Regarding ‘Pay for Performance for Patients’. J GEN INTERN MED 23, 1647–1652 (2008). https://doi.org/10.1007/s11606-008-0739-1

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  • DOI: https://doi.org/10.1007/s11606-008-0739-1

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