Second, performance thresholds for maximum payment are set below 100% [ 1].
The 'incentivised health gain' is the health gain at the performance threshold for maximum payment.
For our secondary analysis we examined the relationship between the total payment and health gained at the performance target for maximum payment.
First we conducted a sensitivity analysis using the maximum number of achievable lives saved as practice performance often exceeded the upper threshold target for maximum payment.
We found that the quality of care for hypertension was improving and already close to the threshold set for maximum payment in the pay for performance initiative.
The setting of the indicator thresholds for maximum payment close to prevailing practice may have provided little incentive for further improvement.
2. to estimate how much of the gap is attributable respectively to thresholds for maximum payment set at less than 100%, and to exception reporting.
Payments are staged, and to be eligible for maximum payment practices are required to achieve a minimum target before they are paid that is, the lower threshold and a maximum or upper threshold.
In addition no associations were found between the size of financial payment for achievement of an indicator and the expected health gain at the performance threshold for maximum payment measured in lives saved or quality adjusted life years.
Our estimates of marginal incentive for a one percent point improvement in health gain are not affected by this problem, so long as baseline performance is below the target for maximum payment.
