Pay for performance: pay more or pay less?

Several recent publications in the radiology literature have reported on the growing phenomenon of pay for performance. This potent new business model seeks to reward health care providers with financial incentives for improvements in the performance and delivery of medical services. This paper briefly reviews some of the obstacles to the implementation of this strategy in the practice of radiology. Radiologists are encouraged to participate actively with payers in discussions about improving quality care but should carefully consider the potential contractual implications associated with these initiatives.