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. 2020 Oct;18(5):655-667.
doi: 10.1007/s40258-020-00572-x.

Effects of Monetary Incentives in Physician Groups: A Systematic Review of Reviews

Ann-Kathrin Heider  1 , Harald Mang  2
Affiliations

Effects of Monetary Incentives in Physician Groups: A Systematic Review of Reviews

Ann-Kathrin Heider et al. Appl Health Econ Health Policy. 2020 Oct.

Abstract

Background: Reimbursement systems that contribute to the cooperation and integration of providers have become increasingly important within the healthcare sector. Reimbursement systems not only serve as payment mechanisms but also provide control and incentive functions. Thus, the design of reimbursement systems is extremely important.

Objectives: The aims of this systematic review were to describe and gain a better understanding of the effects of monetary incentives in the setting of physician groups.

Methods: In January 2020, we searched the MEDLINE (PubMed), Cochrane Library, CINAHL, PsycINFO, EconLit, and ISI Web of Science databases as well as the gray literature and authors' personal collections.

Results: We included 21 reviews containing seven different incentive schemes/initiatives. The study settings and outcome measures varied considerably, as did the results within the incentive schemes and initiatives. However, we found positive effects on process quality for two types of incentives: pay-for-performance and accountable care organizations. The main limitations of this review were the variations in study settings and outcome measures of the studies included.

Conclusions: Monetary incentives in healthcare are often implemented as a control measure and are supposed to increase quality of care and reduce costs. The heterogeneity of the study results indicates that this is not always successful. The results reveal a need for research into the effects of monetary incentives in healthcare.

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Conflict of interest statement

Ann-Kathrin Heider and Harald Mang have no conflicts of interest that are directly relevant to the content of this review. The present work was performed in fulfillment of the requirements for obtaining the degree “Dr. rer. biol. hum.” by AH from the Friedrich-Alexander-Universität Erlangen-Nürnberg.

Figures

Fig. 1
Fig. 1
Number of reviews among AMSTAR quality levels
Fig. 2
Fig. 2
Success factors for different reimbursement schemes found by Eijkenaar [67], Park et al. [68], and Conrad [69]. FFS fee for service
See this image and copyright information in PMC

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