Designing a Performance-Based Payment Model for Physicians in Iran: A Case Study

Researchers at Iran University of Medical Sciences have designed a performance-based payment model for physicians in outpatient clinics contracted with the Iran Health Insurance Organization. This study aimed to enhance physician productivity, clinical service quality, and patient satisfaction by implementing a payment system that rewards high-performing physicians. The research team employed a mixed-methods approach, combining quantitative and qualitative data collection and analysis, to identify 24 key indicators of performance.

Key Takeaways:

• The performance-based payment model was designed to guide physicians toward achieving organizational goals such as cost reduction, process efficiency, and improved patient satisfaction.
• The model uses 24 key indicators, including 9 for general physicians and 13 for specialized physicians, to assess performance dimensions such as medication prescription, diagnostic procedures, and patient satisfaction.
• The indicators were categorized into current, transitional, and desired statuses, aligned with organizational infrastructures.
• The proposed model clarifies expectations and assesses various performance dimensions to enhance physician performance and align it with the objectives of the Health Insurance Organization.
• Policymakers can use this model to drive systemic improvements in healthcare delivery.
• The model was tailored to the specific context and structure of the Iran Health Insurance Organization.

Statistics:

• 24 key indicators were identified to assess performance dimensions.
• 9 indicators were used for general physicians.
• 13 indicators were used for specialized physicians.
• 47 performance indicators were identified through a literature review and expert interviews.
• 18 selection criteria were used to prioritize the indicators.
• 49 questionnaires were used to prioritize the indicators.

Sources:

• NewsRx. Researchers at Iran University of Medical Sciences Release New Data on Preventive Medicine (Designing a performance-based payment model for physicians at outpatient clinics contracted with Iran health insurance: a case study from Iran). Health & Medicine Week. August 22, 2025; p 71.
• Journal of Preventive Medicine and Hygiene. Designing a performance-based payment model for physicians at outpatient clinics contracted with Iran health insurance: a case study from Iran. 2025;66(1).