Hospital executives' perspectives on pay-for-performance and racial/ethnic disparities in care

Med Care Res Rev. 2010 Oct;67(5):574-89. doi: 10.1177/1077558709354522. Epub 2010 Jan 6.


With increasing attention paid to reducing racial/ethnic disparities in care and the growth of pay-for-performance programs, policy makers and payers are considering the use of such incentive mechanisms to target disparities reduction. This article describes the results of qualitative interviews with hospital executives to assess the potential impact that such programs would have on hospitals and their minority patients. The authors find that executives have significant concerns regarding funding mechanisms and implementation costs, financial risks for safety net hospitals, and resource constraints, as well as how such programs can be used to create incentives to care for minority patients. The findings suggest that payers should be hesitant to use pay-for-performance as a mechanism for reducing disparities until a wide variety of concerns about the design of such programs can be addressed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude to Health
  • Continental Population Groups* / statistics & numerical data
  • Ethnic Groups* / statistics & numerical data
  • Healthcare Disparities* / economics
  • Healthcare Disparities* / statistics & numerical data
  • Hospital Administrators*
  • Hospital Costs
  • Humans
  • Interviews as Topic
  • Minority Groups / statistics & numerical data
  • Reimbursement, Incentive* / statistics & numerical data