Harkness Project Title: The Impact of Pay-for-Performance on Health Care Inequalities
Mentors: Arnold M. Epstein, M.D., and Meredith B. Rosenthal, Ph.D.
Placement: Harvard School of Public Health
Biography at time of Harkness Fellowship: Tim Doran, M.D., a 2009–10 Commonwealth Fund Harkness Fellow in Health Care Policy and Practice, is a clinical research fellow in public health in the National Primary Care Research and Development Centre at the University of Manchester. In this position, he leads research on family practice performance on the U.K.’s Quality and Outcomes Framework, and provides advice to the U.K. Department of Health and the National Institute for Health and Clinical Excellence (NICE). He also teaches epidemiology and medical science research in the master's and undergraduate programs and is a member or advisor on a number of regional, national, and international health organizations. His research interests include the effects of socioeconomic inequalities on health and policies to address health inequalities, specifically financial incentives among primary care providers.
Project: Tim Doran aimed to gain a deeper understanding of the effect of pay-for-performance programs on unincentivized aspects of care and on health care disparities in England and the United States. The English arm of the study analyzed the national primary care pay-for-performance scheme, the Quality and Outcomes Framework (QOF). The U.S. arm of the study analyzed data from the diabetes-linked pay-for-performance scheme operating within the Minnesota state Medicaid program.
Career Activity Since Fellowship
- Clinical Research Fellow, National Primary Care Research and Development Centre, University of Manchester, 2013
Current Position: (updated 7/2013)
- Professor of Health Policy, University of York
Email: [email protected]
Harkness-Related Publications
Schmidt H, Stock S, and Doran T, "Moving Forward with Wellness Incentives Under the Affordable Care Act: Lessons from Germany," The Commonwealth Fund, May 2012.
Ryan AM, Blustein J, Doran T, Michelow MD, Casalino LP. “The Effect of Phase 2 of the Premier Hospital Quality Incentive Demonstration on Incentive Payments to Hospitals Caring for Disadvantaged Patients.” Health Services Research. 2012. doi: 10.1111/j.1475-6773.2012.01393.x
Ryan A, Doran T. “The Effect of Improving Processes of Care on Patient Outcomes: Evidence from the United Kingdom’s Quality and Outcomes Framework.” Medical Care. 2011.
Kontopantelis E, Doran T, Gravelle H, Goudie R, Sicilian L, Sutton M. “Family Doctor Responses to Changes in Incentives for Influenza Immunization under the U.K. Quality and Outcomes Framework Pay-for-Performance Scheme.” Health Services Research. 2011.
Doran T, Kontopantelis E, Valderas JM, Campbell S, Roland M, Salisbury C, Reeves D. “Effect of financial incentives on incentivized and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework.” BMJ 2011; 342:d3590 diuL 10.1136/bmj.d3590.
Blaustein J, Weissman JS, Ryan AM, et al. “Analysis Raises Questions on Whether Pay-For-Performance In Medicaid Can Efficiently Reduce Racial And Ethnic Disparities,” Health Affairs 2011; 30(6).
Doran T, Kontopantelis E, Valderas JM, et al. “Effect of financial incentives on incentivized and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework.” BMJ 2011; 342:d3590 diuL 10.1136/bmj.d3590.
Dusheiko M, Doran T, Gravelle H, Fullwood C, and Roland M. “Does Higher Quality of Diabetes Management in Family Practice Reduce Unplanned Hospital Admissions?” Health Services Research 2010; DOI: 10.1111/j.1475-6773.2010.01184.x.
Doran T, Roland M "Lessons from Major Initiatives to Improve Primary Care in the United Kingdom," Health Affairs, May 2010; 29(5): 1023-29.