Embargoed for Release:
For More Information Contact:
Monday,
Feb. 6, 12 a.m., PST
Daniel Danzig, 925-216-8153
danzigpr@comcast.net
INTEGRATED
HEALTHCARE ASSOCIATION
SHARES FIVE YEARS OF EXPERIENCE IN PAY FOR PERFORMANCE WITH
HEALTHCARE LEADERS AT NATIONAL CONFERENCE
Releases
Five-Year Strategic Plan
OAKLAND,
Calif., Feb. 6, 2006 – The Integrated Healthcare Association (IHA) released a
report today detailing lessons learned from the nation’s largest and most
comprehensive quality incentive program for physicians, and offering guidance to
other efforts around the country. Drawing on five years experience administering
the Pay for Performance (P4P) program, the report also lays out a strategic plan
for the next five years. It was released during the National Pay for Performance
Summit in Los Angeles, California.
P4P
involves 225 physician groups representing approximately 35,000 doctors who
provide care for 6.2 million HMO patients in California.
“Pay
for Performance has been a successful collaboration of physicians, health plans,
consumers, and those who pay for healthcare. California’s P4P program should serve as an inspiration for
any group attempting to advance healthcare quality improvement,” said Steve
McDermott, CEO of Hill Physicians, Inc., and chair of the P4P planning committee
that produced the report.
IHA’s
P4P program just completed three full measurement years with reporting of
results and payments for the first two years. As a result of meeting performance
targets, physician groups have received a combined total of approximately $90
million in 2003/2004 P4P-related bonus payments from seven participating health
plans. Payouts based on performance
in 2005 will be made later this year.
“Physicians
are embracing new approaches to creating breakthrough quality improvement,”
said Bart Asner, MD, CEO of Monarch HealthCare. “Measurable quality improvements and enhanced patient
experience demonstrate that P4P has proven to provide important benefits for
patients as well as physicians and health plans.”
Lessons Learned
According to the report, fundamental components of
California’s program are replicable in Medicare and other potential P4P
programs. (The
full report, “Advancing Quality through Collaboration:
The California Pay for Performance Program,” is available at www.iha.org.)
“During
P4P’s first five years, we established a model to allow competing health plans
to cooperate on the use of standardized incentives to help physicians meet
evidence-based quality performance targets,” said Jenni Vargas, IHA board
chair and health care delivery officer for Health Net of California. “Though
California is a unique market in many ways, much of what we have accomplished
can be adapted in other communities,” she said.
In addition to specific lessons learned, the report
emphasizes the ‘power of multiples’ through uniform measurement, common
reporting, data aggregation, and payment by multiple sources of funding.
The program also uses public reporting and peer recognition, as well as
payment incentives, to motivate good performance. Trust among participants was
enhanced by ensuring transparency in all aspects of the program, including
governance and reporting.
The
report also looks ahead to the next five years:
“These
priorities address the need to keep plans, physicians, and purchasers
engaged,” said Tom Williams, executive director of IHA.
“Against all odds, competing health plans and physician groups have
worked together to create an approach to measuring quality that satisfies and
motivates physicians and helps consumers make wise choices.
We’re building on this foundation and strengthening the program,” he
said
About
P4P
Each
year physician groups are awarded bonus payments for reaching P4P evidence-based
performance goals in three areas: clinical measures, patient experiences, and
investment in information technology (IT).
In addition to financial incentives, physician group scores on patient
experience measures are reported on the Office of Patient Advocate’s public
Web site, www.opa.ca.gov.
From
2003 to 2004 -- the two measurement years in which performance results have been
analyzed -- clinical results improved from 1 to 10 percent for all measures.
Patient experience scores improved across each of the measures. Dramatic
improvements have been made in IT adoption with a 54% increase in groups
qualifying for IT credit. (Detailed results are available at www.iha.org.)
Participating
P4P health plans are: Aetna, Blue Cross of California, Blue Shield of
California, CIGNA Healthcare of California, Health Net of California, PacifiCare
(California), and Western Health Advantage. P4P incentive payments do not
represent total incentive amounts paid by plans to physician groups. Plans also
pay incentives for non-IHA sponsored quality measures and to promote better data
collection, generic pharmacy utilization, and other purposes.
IHA (www.iha.org)
is a statewide collaborative of California health plans, physician 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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