Healthgrouper Summit #1

Skopje, December 16th 2012 (Sunday 10.00h)

Hotel Holiday Inn

Open on „Pay for performance“ Who wins, who loses?

(December 11th 2012) - Healthgrouper organizes first International Summit on Pay for Performance in Skopje, Macedonia. Leading international and domestic experts are invited to discuss various options in design similar reforms in the world. The purpose of the Summit is to provide answer to several key questions: Who wins, and who loses with this reform? What are the threats and where are the opportunities in designing P4P reforms? How to make it work? Click here to download detail Summit agenda.

The international experiances of similar reforms on pay for performance will be presented by two leading experts in the field. Dr Christiaan Lako is an assistant professor at the department of Public Administration of the Radboud University Nijmegen, the Netherlands. He published over 60 articles in national and international journals about health policy. He is co-author of one of the background papers for the Summit that was published last week in Journal of healthcare management.

The other international expert is Dr Franz Porzsolt who is the head of clinical economics at the Institute of History, Philosophy, and Ethics in Medicine at the University of Ulm in Germany. He established the Clinical Economics Group, which is involved in developing tools for assessing the (non- monetary) values of medical interventions from the patient's point of view. He is author and co-author of many scientific articles and books among which the popular book "Optimizing Health: Improving the Value of Healthcare Delivery"

The purpose of this Summit is to provide answer to several key questions: Who wins, and who loses with this reform? What are the threats and where are the opportunities in designing P4P reforms? How to make it work?

Beside the international experts, respective group of domestic experts will discuss various options in design of "Pay for performance" schemes. The conference is expected to provide opportunity for open debate on P4P in Macedonia and internationally.


The Ministry of health of the Republic of Macedonia embarked to develop and implement new financial incentives to doctors employed in the public hospitals to improve quality of the delivered health care services. Pay-for-performance (P4P) is one of the mechanisms that gained momentum over the past ten years in health policy making circles. This policy approach is aimed to incentivize doctors and providers towards improved performances to increase quality of care, improve efficiency and reduce costs. The initial enthusiasm and success in the implementation of variations of P4P projects is still put under challenge since there is no clear and replicated evidence in the success of these policies. Existing evidence suggests that there is no straightforward model of successful P4P project. Namely, there are growing concerns among policy makers whether this approach will improve value for health and policy makers’ dilemmas are isn’t it premature to foster it further without clear evidence base. Three months after its implementation the new reform created enormous frustration and distress among great majority of the doctors and physicians started a general strike against this reform. This is the first general strike of doctors over policy reform since the independence of the country in 1991.

Background papers

1. Rosenau PV el al. Managing Pay for Performance: Aligning Social Science Research with Budget Predictability. Journal of Healthcare Management 57:6 Nov/Dec 2012.

2. Lazarevik V, Kasapinov B. Medical Doctors Attitudes Over Pay for Reporting in Macedonia: A web based email survey. Macedonian Journal of Medical Sciences. Dec 2012.

About Healthgrouper is an internet service for communication between doctors and offers the patients complete information about doctors and healthcare providers in South-East Europe. Healthgrouper conducts research in all countries where it is active, in order to make comparative analyses of the conditions in the health systems in the region and improve the quality of healthcare. The results of the surveys are published in the media and available on the following link. Healthgrouper is a registered trademark in the EU Countries.