January 15, 2002
Contact: Jani Bergan
Ogilvy Public Relations Worldwide
415-677-2829 direct line415-640-0565 (cell phone)
jani.bergan@ogilvypr.com
FOR IMMEDIATE RELEASE
CALIFORNIA HEALTH PLANS ANNOUNCE FIRST STATEWIDE, MULTI-PLAN INITIATIVE TO REWARD PHYSICIAN GROUPS FOR QUALITY CARE
Unprecedented Collaboration by Six Leading Health Plans Will Improve Health Care
Delivery and Create Systemic Improvements that Benefit All Consumers
WALNUT CREEK, CA
– The Integrated Healthcare Association (IHA), a statewide leadership
group active in health policy and managed care issues, today unveiled a
groundbreaking initiative that will change the way six of the largest HMOs in
California evaluate and reward their contracted physician groups. The six
health plans – Aetna, Blue Cross of California, Blue Shield of California.
CIGNA Healthcare of California, Inc., Health Net, and PacifiCare – serve more than 8 million Californians.
Under the new Pay for Performance initiative, they will utilize a common
scorecard to measure the performance of their physician groups and pay
incentives based on that performance. Some health plans will begin
implementing the new system in 2002. By 2003, all six HMOs will have this
Pay for Performance process in place.
“These health plans are showing real leadership,” noted
Beau Carter, executive director of the IHA, which spearheaded the development of
the effort. “In an otherwise highly competitive marketplace, where
health plans naturally want to differentiate themselves, these plans have seen
this as the right thing to do: measure and reward quality of service and
quality of care. Pay for Performance will improve the quality of health
care for millions of Californians, focus national attention on a new paradigm of
promoting accountability for results and rewarding excellence, and re-establish
the partnership between health plans and physician groups in managing care.”
The
new Pay for Performance system will utilize a common scorecard for the physician
groups, representing a balance of prevention, chronic care management, and
patient satisfaction measures. An
independent entity will validate the data and publish the results.
The individual health plans will then provide incentive payments to the
physician groups based on this performance, with the amount and nature of the
payment varying by plan. All
physician groups will be eligible for the performance-based payments and will be
rewarded for year-to-year improvements as well as current performance.
“We have finally
created a business case for quality at the physician group level,” said Steve
McDermott, president and CEO of Hill Physicians Medical Group and chair of the
IHA board of directors. “We now
have an opportunity for significant financial rewards if we do a good job.
Our patients will be healthier, and our physicians will be happier.
Physician groups are eager to get started.”
The Pay for
Performance initiative has been under development for more than a year.
IHA member GlaxoSmithKline provided funding for the collaborative design
process, which included employer, health plan, and physician group executives.
“This
is a major breakthrough,” said Peter Lee, president and CEO of the Pacific
Business Group on Health. “Purchasers
are very interested in making standardized, comparative quality data available
to consumers and in rewarding better quality.
This initiative does both in ways that are significant for both patients
and doctors.”
Pay for Performance
will be managed by a Steering Committee of business, HMO, physician group, and
consumer representatives under the umbrella of the IHA.
A Technical Committee working on constant improvement of the specific
performance measures also includes experts from the National Committee on
Quality Assurance (NCQA), the UC Berkeley Center for Health Research, and the
UCSF Institute for Health Policy Studies.
IHA (www.iha.org) is a statewide leadership group of health plans,
physician groups, and health care systems, plus at-large academic, purchaser,
consumer, and pharmaceutical industry representatives, committed to
policy development, public dialogue, and special projects associated with the
continuing evolution of managed health care.
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