This study evaluates the effectiveness of offering adjunctive financial incentives for abstinence (contingency management [CM]) within a safety net hospital smoking cessation program.

It concludes that offering small financial incentives for abstinence might be an effective means to improve abstinence rates among socioeconomically disadvantaged individuals participating in smoking cessation treatment.

The logic of paying more for high-quality care and less for low-quality resonates. Increasingly health system leaders worldwide acknowledge that payment reforms are needed to do just that, prompted no doubt by the growing body of evidence indicating that quality is not what it should be. This review was undertaken to explore contexts in which quality-based payment appears feasible.

This presentation tells you everything you need to know about P4P, specifically related to paying health care providers. Examples from the USA, UK, Brazil and Haiti are included, as well as:

  • Performance Incentives to Households and/or Providers
  • Paying Providers Based on Performance
  • Types of Measures
  • Different Methods to Pay Based on Performance
  • What is Financial Risk for providers under P4P?


From a World Bank-World Health Organization Strategic Purchasing Workshop in Bangkok in December 2009.

A Toolkit on Performance-Based Contracting for Health Services: A new publication in the HNP Series, with support from WBI, provides governments, task teams, NGOs, and other interested stakeholders with a practical, “how-to” guide to contracting. Written by Benjamin Loevinsohn with help from many others, the toolkit takes people through the contracting cycle and systematically explores important issues.


Pay for performance (P4P) is an innovative approach that explicitly links financial investment in health to health results. While the P4P concept seems relatively straightforward, the mechanics of its implementation need to be planned very carefully to elicit the desired behavior change in a given country. To facilitate this planning, USAID through its Health Systems 20/20 project has developed the P4P Blueprint Guide.

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