Table 2.

Healthcare Incentives Reporting Framework (HISReF) - a template for reporting standard features of P4P schemes

Core design features	Variables	Description
Who receives the incentives?	Individuals	Incentive is paid to an individual health care provider e.g. physician
	Groups	Incentive is paid to a group and individual clinicians might not benefit from the incentive directly e.g. hospital trust, clinical team, general physician (GP) practice, NGO, levels of government, faith based organizations
Type of incentive	Bonuses	Incentive is in the form of increase in payments, bonus, gifts, peer recognition etc.
	Fines	Negative incentives in the form of reduction in expected payments, penalty, punishment etc.
Type of payment	Monetary	Incentive in form of money
	Non-Monetary	Incentives in the form of material things or tangible gifts
Size of incentive	Large	Monetary or non-monetary reward or fine- > 10% of salary, budget, or anticipated payment
	Medium	Monetary or non-monetary reward or fine 5–10% of salary, budget, or anticipated payment
	Small	Monetary or non-monetary reward or fine < 5% of salary, budget, or anticipated payment
Payment mechanism	Absolute	Incentives are paid as a single payment for an absolute increase in performance for example, an 80% increase in performance.
	Tiered thresholds	Incentives are paid for a series of target thresholds to meet for example paying increasing incentives for achieving a 65%, an 80%, and a 90% performance threshold.
Method of payment	Coupled	Incentives paid are coupled with usual reimbursement e.g. an incentive in form of an increase in salary.
	Decoupled	Incentives are paid separately from the usual reimbursement.
Performance measure/payment scale	Absolute measure	Incentive is paid for improvement in performance or behaviour change not dependent on other providers e.g. incentive paid per patient immunized
	Relative measure	Incentive is paid for attaining a level of performance relative to other providers e.g. incentives paid to clinicians or hospitals above the median performance
Domain of performance measured	Within clinicians control	Incentive payments are based on process and structural outcomes e.g. having the right equipment, the number of children immunized, routine measurement of blood pressure of patients every month
	Out of clinicians control	Payment of incentives to health providers for ultimate health outcomes e.g. reduction in mortality rates from a specific disease
Time lag	Short	Payment of incentives four months or less after measurement of performance
	Long	Payment of incentives more than four months after measurement of performance