Physicians respond to pay-for-performance incentives: larger incentives yield greater participation.

OBJECTIVE: To determine the extent to which the size of the available financial incentive influences a physician's decision to participate in a pay-for-performance (P4P) program.

STUDY DESIGN: Statistical analysis of historical data from Bridges to Excellence (BTE).

METHODS: Setting available financial incentives as the independent variable and physician participation rates as the dependent variable, we applied regression analysis to BTE's data from selected sites to explore the relationship of fixed bonus-based incentive programs to physician participation rates in those programs.

RESULTS: The amount of incentives available to physicians strongly affected their rate of participation. Participation rates varied with the type of program, and overall physician participation rates might grow as more purchasers/payers within a community offer similar incentives.

CONCLUSION: Our analysis suggests that all stakeholders--health plans, physicians, and patients--would benefit from health plans collaborating on their P4P efforts to maximize physician participation.