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Furthermore, choosing amongst physician and system engineering initiative in designing the program poses an aggravated trial in the long run. Quality measures and incentive structure further contributes to the complex nature of P4P program design. Healthcare providers raise anxiety on the significance of performing well on quality measures. Incentive structure design can create divisions between physicians and program sponsors on several concerns that regard to the structure of incentives (Eijkenaar, 2013). Unintended consequences is another challenge when it comes to this program. According to surveys, physicians disclose limited concerns about
3Pay for Performanceunintended consequences and some further adverse effects on innovation considering the safety posed by unique risks of P4P. The P4P initiatives goal is to aid excellence and efficiency and in turn reduce health care costs. Government agencies are currently revolutionizing by setting programs for health care providers so as motivate them to encounter values. According to a study done by Mechanic and Atman (2009), P4P showcases little gain in quality for the value of money used, and providers are in some cases rewarded high-performance baseline. For this reason, there is a vital concern ofhow the P4P programs should target physicians. Evaluation of providers is faced by several issues like whether they should be based on behavior, rate of improvement or performance rate. Pay for performance programs thus brings in additional factors such as promoting quality healthcare. Also, adequate performance yields increased rewards which are the case with the adoption of P4P programs in health care delivery in hospitals. Pay for further performance