P4P in the UK

General Practitioners (GPs) in the UK NHS are paid a mixture of capitation, lump sum allowances, and a pay-for-performance bonus. The P4P element, the Quality and Outcomes Framework (QOF), rewards GPs according to their performance on a large number of indicators. QOF payments represented up to 20% of GPs ’ income in the first year…

Why operations in Great Britain are being cancelled

On Wednesday, many of the NHS workers went on strike.  Seven thousand of the day’s 30,000 operations were cancelled. Why are workers striking?  One reason is pensions.  According to a new government plan, workers would be required to increase their pension contributions 3.2 percentage points without seeing an increase in the value of their pensions.  Additionally,…

Health Reform in the UK

Health Reform in the U.S. means more government involvement in health care.  More public insurance (expanding Medicaid), more government intervention in the insurance market (health exchanges), and government being a driving force for innovation (the Center for Medicare and Medicaid Innovation). In the UK on the other hand, “Health Reform” means more privatization, not less.  As…

Price Competition for UK Hospitals?

Is health reform coming to the UK?  Since the middle of the decade, the NHS has used a tariff system which pays a fixed price per procedure. Now, however, the Financial Times, reports that the UK plans for “public and private hospitals to compete on price for the treatment of NHS patients.”  The reform calls…

Did pay-for-performance work in the UK?

A paper by Sutton, Elder Guthrie and Watt (2010) describes the UK’s National Health Service’s (NHS) adoption of the Quality and Outcomes Framework (QOF) in April 2004. In general, P4P programs can have positive or negative spillovers.  An example of a positive spillover would be the adoption of EMR to comply with certain P4P initiatives,…