Pay for performance in Estonia: A transformative policy instrument to scale up prevention and management of noncommunicable diseases (2015)




In 2006, Estonia introduced the Quality Bonus System (QBS)—a pay-for-performance instrument that provides financial rewards to primary health care physicians when they reach service provision targets in disease prevention and management. Less than a decade since the programme's launch and for a cost of less than 2% of Estonia's primary health care budget, the incentive programme has resulted in ignificant year-on-year scaling up of disease prevention and management in Estonia.