en Health Policy مروری Review Article <span style="font-size:12pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:#0d0d0d">Background:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:#0d0d0d"> Performance-based payment refers to an incentive-based payment to employees in terms of and beyond their job requirements at an extremely high quality. Therefore, this study aims to review the challenges of performance-based payment in the healthcare system.</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:#0d0d0d">Methods:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:#0d0d0d"> The study was carried out as a systematic review through searching databases, i.e., PubMed, Web of Science, and Scopus, for articles published without time limitation to September 30, 2020. The research articles regarding Performance-based payment in hospitals (n = 16) were examined.</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:#0d0d0d"><span style="letter-spacing:-.1pt">Results:</span></span></span></span></b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:#0d0d0d"><span style="letter-spacing:-.1pt"> Generally, challenges of performance-based payment were divided into four main categories and 17 subcategories, including service providers, payment and financing, quality of provided services, and infrastructure. The main themes and sub-themes were related to the lack of financial resources, discrimination between patients, and the designing of a comprehensive information system.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="line-height:115%"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:#0d0d0d">Conclusion:</span></span></span></b><span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:#0d0d0d"> Suitable implementation of performance-based payment methods in the healthcare system will improve quantitative and qualitative indicators of staff performance. Identifying the challenges and obstacles to the proper implementation of this plan will help health managers and policymakers design and implement remedial measures. It is to reduce the barriers and problems.</span></span></span></span></span></span><br> &nbsp; Performance-based payment, Payment system, Health system, Challenge 285 297 http://jebhpme.ssu.ac.ir/browse.php?a_code=A-10-367-1&slc_lang=en&sid=1 Seyed Mehdi Paknejad Rizi No Department of Healthcare Services Management, School of Health Management & Information Sciences, Iran University of Medical Sciences, Tehran, Iran Fatemeh Torabi fatemehtorabi1374@gmail.com Yes Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Hamideh Jafari Pavarsi No Department of Digital library, The Special Library of the Academy of Art, Tehran, Iran