Pay for performance

Viele Geschäftsführungen denken derzeit über die Aktualisierung bestehender Vergütungs- und Anreizsysteme oder über deren erstmalige Einführung zum nächsten Geschäftsjahr nach. Doch der Anreizschuss kann auch nach hinten losgehen. Manch einer der Mitarbeiter erkennt zwar hierin die Chance, sich durch zielgerichtetes Arbeiten finanziell zu verbessern – und nimmt diese Möglichkeit auch engagiert wahr. Andere aber befürchten, dass das Teamwork leidet, wenn sich alle künftig nur um ihre eigenen Ziele kümmern und die nicht vergütungsrelevanten Aufgaben vernachlässigen. Sind variable Vergütungssysteme ein Pulverfass, das Sie besser meiden sollten? Nein, denn für solche Befürchtungen gibt es längst wirksame Lösungen.

Wolf, Gunther: Variable Vergütungssysteme gestalten. In: Business24.ch (20.08.). Luzern: Belmedia 2015.

Mathematica's rigorous evaluation of the Teacher Incentive Fund (TIF) will estimate the impact of performance pay on student achievement, as well as educators' attitudes toward and awareness of TIF and their mobility and recruitment. This report provides contextual background on performance pay programs, characteristics of participating TIF grantee schools, and details on the TIF evaluation study design.

The concept of pay-for-performance (P4P) encompasses different strategies that aim to stimulate health care quality improvement by remunerating healthcare providers according to their performance in specific measures of efficiency or quality. Although the effectiveness of P4P in improving quality of care is largely unknown, these systems are being widely adopted in the United Kingdom, the United States and other countries, including Spain. The elements of P4P design that are most decisive for the effectiveness of these schemes are as follows: 1) who should receive the incentives, how they should be paid, what should be rewarded, the need to incorporate risk adjustments (mainly if surrogate outcomes are used as indicators) and the need to bear organizational climate and the optimal combination of financial and non-financial incentives in mind. The most important limitations to consider are the following: 1) the exclusive focus on reducing subutilization; 2) the effect on equity; 3) the "magnifying glass" effect; 4) the validity of indicators; 5) the confusion between the recommendations of clinical guidelines and quality indicators; 6) "document engineering"; 7) paternalism; 8) the negative impact on professionalism and clinicians' internal motivation, and 9) the assumption that quality problems result from imperfect individual decisions rather than from an imperfect system.

Dit artikel beoogt een overzicht te geven van de hervorming van de financiering en organisatie van de algemene ziekenhuizen. Hiervoor wordt teruggegrepen naar de context en de oorsprong van de huidige plannen, om vervolgens de tussenstand van het Plan van Aanpak te bespreken, dat in april 2015 werd gepresenteerd. Verschillende concepten werden reeds op de sector losgelaten. Toch kan de hervorming maar voortgaan op het ritme van de onderzoeken en analyses die deze concepten concreet moeten uitwerken en integreren in de ziekenhuiswerking. De onzekerheid over de toekomst is groot en vereist dat de ziekenhuizen hun gemoedstoestand, te midden van de besparingsgolven, kunnen omschakelen van overleven naar herleven.

Cet article vise à donner un aperçu de la réforme du financement et de l'organisation des hôpitaux généraux. Pour ce faire, nous nous référons au contexte et à l'origine des plans actuels, pour discuter ensuite de la situation intérimaire du Plan d'Approche, présenté en avril 2015. Plusieurs concepts ont déjà été divulgués et introduits au niveau du secteur. Cependant, la réforme ne peut se poursuivre qu'au rythme des études et analyses qui doivent concrétiser ces concepts et les intégrer dans le fonctionnement des hôpitaux. L'incertitude quant à l'avenir est grande et exige que les hôpitaux, pris dans des cycles répétitifs d'exigences d'économies, puissent passer d'un état d'esprit de survie à un état d'esprit de renaissance.

The Sarbanes Oxley Act of 2002 (SOX) introduced several governance reforms that considerably increased the total risk exposure of CEOs. We examine the effects of these regulatory changes on compensation contracts of CEOs and their effect on risk taking subsequent to SOX. We find that while overall compensation did not change, salary and bonus compensation increased and option compensation decreased following the passage of SOX. The sensitivity of CEO’s wealth to changes in shareholder wealth also decreased after SOX. These results indicate that the pay for performance sensitivity of CEO compensation has declined following SOX. Our results indicate that these changes reduced investments in research and development, and capital expenditures. We also document that the above changes in CEOs ’ pay for performance sensitivities and their risky investments following SOX are associated with a reduction in stock return volatility. However, we do not find any evidence indicating that these ch...

Many public sector agencies have begun to align pay with employees' performance rather than tenure. For pay-for-performance and merit-pay systems to be successful, organizations need to ensure that procedural justice and distributive justice exist, the system must be linked to the strategic mission of the organization, employees should participate in the development of the plan, there need to be meaningful distinctions between acceptable and outstanding performance, and costs need to be acknowledged and budgeted during the planning phase of the program.

We investigate the relationship between CEO performance pay incentives and firm productivity. In general, we find an inverse U-shaped relationship between productivity and the sensitivity of CEO wealth to share value (delta) and a positive relationship between productivity and the sensitivity of CEO option wealth to stock return volatility (vega). Thus, a high delta associated with CEO risk-aversion lowers productivity, but a high vega from stock options offsets this effect. In looking at delta and vega jointly, we also find that options do not always achieve their intended purpose. These results are stronger among firms that are weakly governed or when high transaction costs prevent the writing of an optimal compensation contract.

Objective To assess the impact of a pay for performance incentive on quality of care and outcomes among UK patients with hypertension in primary care.Design Interrupted time series.Setting The Health Improvement Network (THIN) database, United Kingdom.Participants 470725 patients with hypertension diagnosed between January 2000 and August 2007.Intervention The UK pay for performance incentive (the Quality and Outcomes Framework), which was implemented in April 2004 and included specific targets for general practitioners to show high quality care for patients with hypertension (and other diseases).Main outcome measures Centiles of systolic and diastolic blood pressures over time, rates of blood pressure monitoring, blood pressure control, and treatment intensity at monthly intervals for baseline (48 months) and 36 months after the implementation of pay for performance. Cumulative incidence of major hypertension related outcomes and all cause mortality for subgroups of newly treated (treatment started six months before pay for performance) and treatment experienced (started treatment in year before January 2001) patients to examine different stages of illness.Results After accounting for secular trends, no changes in blood pressure monitoring (level change 0.85, 95% confidence interval −3.04 to 4.74, P=0.669 and trend change −0.01, −0.24 to 0.21, P=0.615), control (−1.19, −2.06 to 1.09, P=0.109 and −0.01, −0.06 to 0.03, P=0.569), or treatment intensity (0.67, −1.27 to 2.81, P=0.412 and 0.02, −0.23 to 0.19, P=0.706) were attributable to pay for performance. Pay for performance had no effect on the cumulative incidence of stroke, myocardial infarction, renal failure, heart failure, or all cause mortality in both treatment experienced and newly treated subgroups.Conclusions Good quality of care for hypertension was stable or improving before pay for performance was introduced. Pay for performance had no discernible effects on processes of care or on hypertension related clinical outcomes. Generous financial incentives, as designed in the UK pay for performance policy, may not be sufficient to improve quality of care and outcomes for hypertension and other common chronic conditions.

To test whether an integrated delivery system could successfully implement an evidence-based pay-for-performance program for coronary artery bypass graft (CABG) surgery. The program consisted of 3 components: (1) establishing implementable best practices; (2) developing risk-based pricing; (3) establishing a mechanism for patient engagement. Surgeons reviewed all class I and IIa "2004 American Heart Association/American College of Cardiology Guidelines for CABG Surgery" and translated them into 40 verifiable behaviors. These were imbedded within a new ProvenCareSM program and "hardwired" within the electronic health record system, including order sets, templates, and "time outs". Concurrently preoperative, inpatient, and postoperative care within 90 days was packaged into a fixed price. A Patient Compact was developed to highlight the importance of patient activation. All elective CABG patients treated between February 2, 2006 and February 2, 2007 were ...

PurposeThe first goal of this research is to analyse the effects of lean production (LP) on the policy of human resource management (HRM). The second is to determine whether or not implementation of HRM practices associated with LP explains the differences in organizational performance between manufacturing plants.Design/methodology/approachThe paper developed a questionnaire for data collection. Findings are presented from 76 establishments (79.17 per cent of the total sample) that specialise in single‐firing ceramic tiles in Spain.FindingsCompanies that make the most of LP practices are also those that take care to train workers in using these practices as well as improving their employment security. However, the same is not true for the pay for performance system. The combination of LP with HRM practices reduces inventory and boosts productivity but does not appear to affect the other performance variables analysed.Research limitations/implicationsFor certain variables very littl...

Mathematica's rigorous evaluation of the Teacher Incentive Fund (TIF) will estimate the impact of performance pay on student achievement, as well as educators' attitudes toward and awareness of TIF and their mobility and recruitment. This report provides contextual background on performance pay programs, characteristics of participating TIF grantee schools, and details on the TIF evaluation study design.