Value Based Pay for Performance (P4P) Results
IHA’s transition from quality-based to Value Based Pay for Performance (VBP4P) aligns with the national movement toward the use of value based performance measurement and identifies value as the ultimate measurement goal. 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.
Results are based on clinical quality, patient experience, meaningful use of health IT, resource use and total cost of care (TCC) measures. In 2015, TCC reporting included Anthem Blue Cross, Blue Shield of California, Cigna, Health Net, Kaiser Permanente, Sharp, UnitedHealthcare and Western Health Advantage.
Ahead of the Curve
VBP4P participants surpassed CMS 2018 targets announced in early 2015 for Medicare: over 60% of health plan payments to physician organizations for Commercial HMO/POS members are made through the VBP4P incentive design or similar alternative payment model (APM) and all incentive payments are linked to at least quality performance.