Results of the Financial Incentive to Improve Quality (IFAQ) experimental program: towards the generalized model

Abstract

In June 2012, a pilot program, named IFAQ for Financial Incentive to Improve Quality (IFAQ), was introduced in France by the Ministry of Health and the National Authority for Health (HAS) with the methodological support of the research team COMPAQH (EA7348 Healthcare management Research-EHESP). The objective was to design a model that would award a financial bonus to the best performers hospitals based on their results to a set of indicators (HAS indicators, Nosocomial Infections indicators, HAS accreditation measures, Patient Satisfaction, Level of digitization of patient records in hospitals). The IFAQ program lasted 4 years: IFAQ 1 (2012-2014) and IFAQ 2 (2014-2015) and permitted to develop the IFAQ model that was eventually rolled out nationally in 2016 to all French acute care hospitals. The final model is based on a classification of hospitals into 2 groups based on the obligation or not to fill in the patient record indicator. For each hospital of the two groups, two scores are calculated: first, the level of achievement and second the improvement (performance increase) between two campaigns. 20% of the best hospitals in each group and classification can receive a reward. IFAQ was developed with the participation of hospital federations. While the design of IFAQ is based on a robust experimental process, efforts are still needed to reach a good level of awareness of the program among healthcare professionals