Pay-for-performance (P4P) policies and programs (such as the Hospital-Acquired Condition [HAC] Reduction Program) intend to incentivize high-quality care and reduce medical errors. This systematic review including 53 articles explored the impact of P4P on the incidence of adverse events in acute care settings. The researchers found that half of the included studies did not identify improvements in adverse event rates after P4P, and that studies reporting improvements were of poor methodological quality.