A group of researchers at Harvard University have designed a system that aligns financial incentives for physicians and hospitals with key measures of performance, hoping to improve health care for millions of patients in some of China's poorest regions.

The initiative, called APPROACH, for Analysis of Provider Payment Reforms on Advancing China's Health, is being conducted in collaboration with provincial governments and with teams from Chinese universities.

The plan is being implemented at 50 hospitals in 28 counties, and is part of a broader effort to improve care at different levels of the nation's health care system.

The effort follows on the Chinese government's 2009 health care overhaul, which more than tripled spending and implemented an insurance system aimed at ensuring access for 1.2 billion people.

The reform made insurance universal and increased participation in the health care system, but without ensuring improvements in quality of care.