July 5, 2005
Contact:
Barry Scholl or Jeff Van Ness
(202) 955-5197 or (202) 955-3518
FOR IMMEDIATE RELEASE
CALIFORNIA PAY-FOR-PERFORMANCE RESULTS SHOW IMPROVEMENTS IN HEALTH CARE
QUALITY
IHA Data Reveal Across-the-Board Gains in Clinical Results, Patient
Satisfaction,
IT
Adoption
WALNUT CREEK, Calif.—The
Integrated Healthcare Association (IHA), a California health care leadership
group, has released performance data for the second measurement year of its
statewide Pay for Performance (P4P) program. The results show gains in each of
the evidence-based measures the program uses to assess the performance of over
35,000 physicians in 225 medical groups. The across-the-board gains are a
promising sign of better care for the more than 6.2 million commercial HMO
enrollees whose health plans participate in the program.
IHA’s P4P program is the largest in the country to provide medical groups with incentive payments based upon performance against quality benchmarks. Seven California health plans participate: Aetna, Blue Cross, Blue Shield, CIGNA, Health Net, PacifiCare and Western Health Advantage. The program’s data is collected and analyzed by the National Committee for Quality Assurance (NCQA), a Washington non-profit dedicated to improving health care quality.
The 225 medical groups
participating in the P4P program posted improvement across all 14 measures of
clinical quality (see attached results). The measures cover preventive services,
such as breast cancer and cholesterol screening, as well as treatment for
chronic conditions such as diabetes and asthma.
“Boosting
the percentage of patients who get the recommended services like Pap smears and
cholesterol screenings is a small step that can save lives,” said Mark Smith,
M.D., M.B.A., President and CEO of the California HealthCare Foundation, a major
funder of the P4P initiative. “The
improvement in cervical cancer screening rate documents an additional 117,000
women in California who received this potentially lifesaving screening last
year.”
The results were welcome news to program participants. “The premise of the P4P program is simple—set high standards for quality and reward those who meet or exceed the standards,” said Lance Lang, M.D., Vice President and Senior Medical Director, Health Net of California. “We can have confidence that the gains in quality we see today will be sustained because of the increased investment in information systems. This is the advantage of health plans working with organized medical groups to create a coordinated and systematic approach to quality improvement.”
The P4P program also assesses the investment in, and adoption of, information technology (IT) to support patient care. Of the 225 participating medical groups, 119 (53%) met some or all of the program’s IT criteria, a marked increase from the 74 groups that met IT standards in 2003. Several recent studies, including the Institute of Medicine’s Fostering Rapid Advances in Health, have shown that adoption of IT systems for purposes such as building patient registries for at-risk or chronically ill patients and using electronic decision support systems at the point of care can lead to substantial improvements in the quality of care.
This proved to be the case in IHA’s P4P program: the medical groups who received full credit on the IT measures had average clinical scores that were nine percentage points higher than medical groups who showed no evidence of IT adoption.
"IHA's pay-for-performance
program demonstrates that health IT adoption leads to better performance. Its
promotion of health IT is a model for others to follow," said David Brailer,
M.D., Ph.D., National Coordinator for Health Information Technology. "The
increase in IT adoption among the medical groups that participated in this
program is to be applauded - it promises improved quality of care for all
Californians."
The 225 participating medical groups also collectively improved from 2003 across all six patient satisfaction measures.
“Feedback from the P4P program helps us determine where we perform at a high level and where we should direct our quality improvement efforts,” said Steve McDermott, Chief Executive Officer, Hill Physicians Medical Group. “P4P has stepped up the pace of improvement for all of us, and the survey results show that our patients notice the difference.”
The results for the 2004 measurement year will be used by participating health plans to calculate the incentive payments they distribute to medical groups between early July and October. Medical group-specific results will also be released to the State of California Office of the Patient Advocate (OPA) for use in its annual public scorecard (www.opa.ca.gov). The scorecard will be published in September in time for employee open enrollment periods.
IHA (www.iha.org) is a statewide collaborative leadership group of California health plans, medical groups, and health care systems, plus academic, consumer, purchaser, pharmaceutical and new technology representatives. IHA promotes quality improvement, accountability, and affordability for the benefit of all California consumers through special projects, policy innovation and education.
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CALIFORNIA
P4P CLINICAL, IT, AND PATIENT SATISFACTION MEASURES, 2003-2004 |
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Clinical Measures |
%
increase from |
2003 Mean |
2004
Mean |
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Breast
Cancer Screening |
1.5% |
64.4 |
65.4 |
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Cervical
Cancer Screening |
8.2% |
62.4 |
67.5 |
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Childhood
Immunizations: DTP* |
84.5%* |
33.4 |
61.5
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Childhood
Immunizations: IPVOPV* |
79.5%* |
37.6 |
67.5 |
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Childhood
Immunizations: MMR* |
14.3%* |
73.1 |
83.5 |
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Childhood
Immunizations: HIB* |
63.0%* |
42.6 |
69.4 |
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Childhood
Immunizations: HBV* |
85.3%* |
28.6 |
53.0 |
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Childhood
Immunizations: VZV* |
17.2%* |
69.0 |
80.9 |
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Asthma:
All Ages |
3.3% |
66.7 |
68.8 |
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Asthma:
Age 5-9 |
8.6% |
68.3 |
74.2 |
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Asthma:
Age 10-17 |
2.7% |
65.5 |
67.3 |
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Asthma:
Age 18-56 |
4.2% |
67.8 |
70.6 |
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Diabetes
Care: HbA1c Screening |
5.3% |
65.8 |
69.3 |
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Cholesterol
Mgmt: LDL Screening* |
15.7%* |
67.7 |
78.3 |
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*
Indicates a change in measure specifications which may be responsible for
some of the year-over-year changes in measure rates. |
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Note:
P4P clinical measures are calculated using only electronic
administrative data and may not be comparable to other similar measures. |
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IT Measures |
%
increase from |
2003 |
2004 |
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Medical
Groups Receiving Credit for IT |
53.8% |
34.4 |
52.9 |
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Integration
of Electronic Clinical Datasets |
70.6% |
27.9 |
47.6 |
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Point
of Care Decision Support Technology |
69.0% |
20.0 |
33.8 |
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Patient
Experience Measures |
%
increase from |
2003 Mean |
2004 Mean |
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How
Well Doctors Communicate* |
1.6%* |
85.6 |
87 |
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Rating
of Doctor |
0.9% |
80 |
80.7 |
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Rating
of Health Care |
2.0% |
70 |
71.4 |
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Problem
Seeing Specialist |
3.0% |
59.5 |
61.3 |
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Rating
of Specialist |
1.3% |
71 |
71.9 |
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Timely
Care and Service Composite* |
7.3%* |
69.5 |
74.6 |
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*
Indicates a change in the survey questions, which may be responsible for
some of the year-over-year changes in measure rates. |
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