Pay-for-performance: toxic to quality? Insights from behavioral economics.

Journal Article (Review;Journal Article)

Pay-for-performance programs aim to upgrade health care quality by tailoring financial incentives for desirable behaviors. While Medicare and many private insurers are charging ahead with pay-for-performance, researchers have been unable to show that it benefits patients. Findings from the new field of behavioral economics challenge the traditional economic view that monetary reward either is the only motivator or is simply additive to intrinsic motivators such as purpose or altruism. Studies have shown that monetary rewards can undermine motivation and worsen performance on cognitively complex and intrinsically rewarding work, suggesting that pay-for-performance may backfire.

Full Text

Duke Authors

Cited Authors

  • Himmelstein, DU; Ariely, D; Woolhandler, S

Published Date

  • January 2014

Published In

Volume / Issue

  • 44 / 2

Start / End Page

  • 203 - 214

PubMed ID

  • 24919299

Electronic International Standard Serial Number (EISSN)

  • 1541-4469

International Standard Serial Number (ISSN)

  • 0020-7314

Digital Object Identifier (DOI)

  • 10.2190/hs.44.2.a


  • eng