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Background Reimbursement systems that contribute to the cooperation and integration of providers have become increasingly important within the healthcare sector. Reimbursement systems not only serve as payment mechanisms but also provide control and incentive functions. Thus, the design of reimbursement systems is extremely important. Objectives The aims of this systematic review were to describe and gain a better understanding of the effects of monetary incentives in the setting of physician groups. Methods In January 2020, we searched the MEDLINE (PubMed), Cochrane Library, CINAHL, PsycINFO, EconLit, and ISI Web of Science databases as well as the gray literature and authors' personal collections. Results We included 21 reviews containing seven different incentive schemes/initiatives. The study settings and outcome measures varied considerably, as did the results within the incentive schemes and initiatives. However, we found positive effects on process quality for two types of incentives: pay-for-performance and accountable care organizations. The main limitations of this review were the variations in study settings and outcome measures of the studies included. Conclusions Monetary incentives in healthcare are often implemented as a control measure and are supposed to increase quality of care and reduce costs. The heterogeneity of the study results indicates that this is not always successful. The results reveal a need for research into the effects of monetary incentives in healthcare.

Background Digital availability of patient data is continuously improving with the increasing implementation of electronic patient records in physician practices. The emergence of digital health data defines new fields of application for data analytics applications, which in turn offer extensive options of using data. Common areas of data analytics applications include decision support, administration, and fraud detection. Risk scores play an important role in compiling algorithms that underlay tools for decision support. Objectives This study aims to identify the current state of risk score integration and integration capability in electronic patient records for cardiovascular disease and diabetes in German primary care practices. Methods We developed an evaluation framework to determine the current state of risk score integration and future integration options for four cardiovascular disease risk scores (arriba, Pooled Cohort Equations, QRISK3, and Systematic Coronary Risk Evaluation) and two diabetes risk scores (Finnish Diabetes Risk Score and German Diabetes Risk Score). We then used this framework to evaluate the integration of risk scores in common practice software solutions by examining the software and inquiring the respective software contact person. Results Our evaluation showed that the most widely integrated risk score is arriba, as recommended by German medical guidelines. Every software version in our sample provided either an interface to arriba or the option to implement one. Our assessment of integration capability revealed a more nuanced picture. Results on data availability were mixed. Each score contains at least one variable, which requires laboratory diagnostics. Our analysis of data standardization showed that only one score documented all variables in a standardized way. Conclusion Our assessment revealed that the current state of risk score integration in physician practice software is rather low. Integration capability currently faces some obstacles. Future research should develop a comprehensive framework that considers the reasonable integration of risk scores into practice workflows, disease prevention programs, and the awareness of physicians and patients.