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Prevention and Promotion Program Performance-Based Payment Effects on the Federation of Bosnia and Herzegovina Family Medicine Teams’ Work

Boris Hrabac, Senad Huseinagic, Rade Bosnjak.


Aim: The aim of this study is to evaluate the effects of „pay for performance“ (P4P) preventive-promotive program within family medicine teams in Bosnia and Herzegovina being reimbursed by bonus payment. Material and methods: The tested model of bonus payment improved provider performance in the intended fashion. Experimental group of teams, being reimbursed by bonus payment, demonstrated significantly higher performance in comparison to control group, being reimbursed by flat rate payment just for proper reporting. Bonus payment encompasses threshold and range for each service being evaluated, as well as ponders for five indicators of performance. Results: The project has developed a standardized approach to preventive and promotive services within family medicine as added value to P4P program, what resulted by improved governance within health care system. Although there are higher values of females being checked-up in the beginning of the program, as well as elderly, this concept is not considered as one to impair equity on the long run. Also there is no tendency to ‘good risk selection phenomena’.

Key words: pay for performance (P4P), preventive-promotive program, family medicine, bonus payment, Bosnia and Herzegovina.

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