Does the frequency of pay-for-performance payment matter? Experience from a randomized trial.

OBJECTIVE: To examine the effects of incentive payment frequency on quality measures in a physician-specific pay-for-performance (P4P) experiment.

STUDY SETTING: A multispecialty physician group practice.

STUDY DESIGN: In 2007, all primary care physicians (n=179) were randomized into two study arms differing by the frequency of incentive payment, either four quarterly bonus checks or a single year-end bonus (maximum of U.S.$5,000/year for both arms).

DATA COLLECTION/EXTRACTION METHODS: Data were extracted from electronic health records. Quality measure scores between the two arms over four quarters were compared.

PRINCIPAL FINDINGS: There was no difference between the two arms in average quality measure score or in total bonus amount earned.

CONCLUSIONS: Physicians' responses to a P4P program with a small maximum bonus do not differ by frequency of bonus payment.