Value Based Pay for Performance (P4P) Results
Initially focused solely on quality, IHA’s Value Based P4P program has evolved into one of the country’s largest alternative payment models by merging quality, patient experience, resource use, and cost measures into a single incentive program across multiple health plans. The program’s ultimate goal is to advance high-quality, affordable, patient-centered care—or high-value care—for all Californians.
Participants include 10 health plans and more than 200 California physician organizations caring for about 9.6 million Californians enrolled in commercial health maintenance organization (HMO) and point of service (POS) products. Results are shared with the California Office of the Patient Advocate (OPA) for public reporting and used to recognize winners of the Excellence in Healthcare Award.
IHA partners with the California Office of the Patient Advocate (OPA) to publicly report Value Based P4P results at the individual physician-organization level. The online OPA Medical Group Commercial Report Card allows users to compare physician organization performance within a county, showing overall performance as well as scores on individual clinical quality, patient experience, and total cost of care measures.
- Health Affairs Blog: Value Milestone - Public Reporting by Physician Organizations of Costs Alongside Quality
IHA also partners with OPA to publish the Medical Group Medicare Report Card for physician organizations caring for seniors and people with disabilities enrolled in Medicare Advantage health plans. IHA supports other public reporting opportunities. For example, IHA in 2016 partnered with Consumer Reports and other Regional Healthcare Improvement Collaboratives to produce a magazine insert displaying the physician organization VBP4P results for selected measures.