The Morality of Using Mortality as a Financial Incentive – Unintended Consequences and Implications for Acute Hospital Care


In this Viewpoint, Joel M. Kupfer, M.D., of Methodist Medical Center and the University of Illinois College of Medicine-Peoria, examines the potential issues of using financial incentives to improve hospital mortality rates.

“Financial incentives can be powerful motivators but the results might not always be beneficial. Changes in program design and more widespread implementation might help overcome prior limitations but the potential for unintended consequences also may increase as the financial imperatives of hospitals to win incentives increases. It is important to move ahead with quality initiatives even though there are gaps in current knowledge. The challenge for policy makers will be to design a balanced system that can lower costs and improve care while preserving the ethical integrity of the medical profession, and respect patients’ rights to make choices about their health care.”

JAMA. 2013;309[21]:2213-2214