Making payment for performance work.

Here we discuss key issues to consider when designing and the steps to implementing a performance incentives program. Among our examples are those that went wrong as well as those that went right because valuable lessons can be learned from each. While some of the issues may seem complicated it is not necessary to get all the details right at the outset: refinements can and should be introduced along the way. Fundamentally different from many traditional approaches to improving the delivery of health services performance incentives are about establishing what the results should be and then letting the key actors -- the patients the providers -- figure out how to achieve them. Along the way learning and fine-tuning are part and parcel of the process. (Excerpt)