Here is a digestible article from NYT that discusses the lack of studies done on quantitatively and qualitatively weighing the costs and benefits of the actual P-for-P deal. The model works well in firms and corporate companies, but does it translate well to the medical field and public health? There's the fear that such initiatives will put a rift in patient-doctor relationship (which is already pretty sucky). From the article:
Even more concerning, however, are the unintended consequences that some of these studies have uncovered. Some pay-for-performance plans have resulted in increased administrative costs. Certain physicians and hospitals have found ways to “work” the system, avoiding patients who require more costly care or who skew quality records and exaggerating the severity of patient status in order to document the kind of dramatic improvement that might result in a bonus.