Pay-for-performance fails to perform

The first large Medicare pay-for-performance program for doctors and medical practices, which ran between 2013 and 2016, failed to deliver on its central promise to increase value of care for patients. The program may have also exacerbated health disparities by inadvertently shifting payments from physicians caring for sicker, poorer patients to those caring for healthier, richer ones. Important similarities between the failed pay-for-performance prototype and its successor suggest the latter may not be sound policy.