A systematic review of the randomized trial literature examining the impact of financial incentives on provider preventive care delivery was conducted. English-language studies published between 1966 and 2002 that addressed primary or secondary preventive care or health promotion behaviors were included in the review. Six studies that met the inclusion criteria were identified, which generated eight different findings. The literature is sparse. Of the eight financial interventions reviewed, only one led to a significantly greater provision of preventive services. The lack of a significant relationship does not necessarily imply that financial incentives cannot motivate physicians to provide more preventive care. The rewards offered in these studies tend to be small. Therefore, the results suggest that small rewards will not motivate doctors to change their preventive care routines.
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Preventive care is under-delivered in the United States. This article reviews the randomized trial literature on the role of financial incentives in physicians’ delivery of preventive care. The literature indicates that small financial rewards will not change physician behavior. However, this conclusion is tempered by the fact that the literature is very sparse. More research is needed to better understand the role of incentives in modifying physician behavior. This work was performed as part of an Evidence-Based Practice Center contract (290-02-0009, task order 1) with the Agency for Health Care Research and Quality. No financial conflict of interest was reported by the authors of this paper.