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Pay-for-performance step-by-step: Introduction to the MIMIQ model


  • Van Herck, Pieter
  • Annemans, Lieven
  • De Smedt, Delphine
  • Remmen, Roy
  • Sermeus, Walter


Objectives Pay-for-performance is increasingly used as a system intervention to support quality improvement. Programs are however developed, implemented and evaluated in a heterogeneous way. This is partly due to the broad and disparate theoretical and empirical foundation of P4P practice, which is rapidly evolving. This paper guides the reader through the essential steps which should be taken into consideration when setting up a P4P program. To this end a model called 'Model for Implementing and Monitoring Incentives for Quality' (MIMIQ) is presented.Methods Literature review was performed with a search of multiple databases, reference screening and expert consultation.Results Central to the step-by-step approach is a Plan-Do-Check-Act cycle which incorporates communication, implementation and evaluation as key phases next to program development. In addition, the model explains how the decision making and results of each phase is modified by contextual factors. The model puts emphasis on quality and quality measurement as first items to develop. Only after these are in place, the development of the incentive component can be addressed.Conclusions The model presents guidance for designing and implementing P4P programs in a practically structured way. According to future findings the MIMIQ model will continuously evolve as an up to date P4P policy and practice tool.

Suggested Citation

  • Van Herck, Pieter & Annemans, Lieven & De Smedt, Delphine & Remmen, Roy & Sermeus, Walter, 2011. "Pay-for-performance step-by-step: Introduction to the MIMIQ model," Health Policy, Elsevier, vol. 102(1), pages 8-17, September.
  • Handle: RePEc:eee:hepoli:v:102:y:2011:i:1:p:8-17

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    References listed on IDEAS

    1. Frolich, Anne & Talavera, Jason A. & Broadhead, Peter & Dudley, R. Adams, 2007. "A behavioral model of clinician responses to incentives to improve quality," Health Policy, Elsevier, vol. 80(1), pages 179-193, January.
    2. Eggleston, Karen, 2005. "Multitasking and mixed systems for provider payment," Journal of Health Economics, Elsevier, vol. 24(1), pages 211-223, January.
    3. Campbell, S. M. & Roland, M. O. & Buetow, S. A., 2000. "Defining quality of care," Social Science & Medicine, Elsevier, vol. 51(11), pages 1611-1625, December.
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    Cited by:

    1. Søren Rud Kristensen & Mickael Bech & Jørgen T. Lauridsen, 2016. "Who to pay for performance? The choice of organisational level for hospital performance incentives," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(4), pages 435-442, May.
    2. repec:eee:hepoli:v:122:y:2018:i:1:p:12-22 is not listed on IDEAS


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