“Success and Failures of Pay for Performance in the UK”,  Martin Roland and Stephen Campbell.  NEJM,  May 15, 2014.

Paying for performance tinkers with quality of care by selecting areas of focus by healthcare providers.  Incentives improve some areas of care but hinder others.  The unintended consequences created by shifting provider attention need to be better understood.   There was no mention in this article about the impact of P4P on cost of care.  Not an issue in UK as it is in the US.

UK spends 8.4% of its GDP on healthcare.  Per capita costs of care are about $3000.

US spends 18% of its GDP on healthcare.   Per capita costs of care are about $7300.

Perhaps the US needs to look elsewhere to address its pressing problems of extremely high costs and low quality.  Transparency of cost and quality in a competitive marketplace where consumers pay a fraction at the time of service…..or a single payer system.  In the US, we do not have the luxury to tinker.