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.