The article examines public policies designed to improve quality and accountability that do not rely on financial incentives and public reporting of provider performance. The authors write that public policies related to quality improvement should focus more on methods of enhancing professional intrinsic motivation, while recognizing the potential role of organizations to actively promote and facilitate that motivation. For example, public policy can support clinicians’ intrinsic motivation to act in their patients’ best interests through approaches that support systematic feedback to clinicians and provide concrete opportunities to collaborate to improve care. Some programs administered by the Centers for Medicare & Medicaid Services, including Partnership for Patients and Conditions of Participation, deserve more attention; they represent available, but largely ignored, approaches to support providers to improve quality and protect beneficiaries against substandard care.
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