Reforming the PCCE Program to Promote Justice and Performance

Project Lead: Ilana Brody

Nudge Unit Team: Hengchen Dai, Jana Gallus, Richard Leuchter, Joseph Reiff, Silvia Saccardo, William Turner, Sitaram Vangala 

Collaborators: Maryann Elegonye, Nika Harutyunyan, Brian Le, Sitaram Vangala

Collaborating Department/Division: Primary Care, DOM Quality

Project description: Financial incentive programs have had limited success in improving physician performance, inspiring calls to incorporate behavioral insights into program design. We designed a randomized controlled trial (RCT) to leverage an under-appreciated driver of incentive programs’ success: procedural and distributive justice, or the perceived fairness of the program’s implementation and outcomes. Physicians were randomized to receive one of three versions of a report about their performance in the incentive program:

1. Status quo reports with a link to view their performance in the incentive program.
2. Personalized reports with performance feedback that aimed to increase the transparency of the incentive program.
3. Personalized reports with performance feedback (as described under #2), combined with information about how physician input influenced the incentive program.

The outcomes being measured include physician performance within the incentive program, physician beliefs about the program, physician program-related and workplace attitudes, and citizenship behaviors.