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Release Feb. 14 12 a.m. PST
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CALIFORNIA HEALTH PLANS PAY OVER $55 MILLION TO PHYSICIAN GROUPS
FOR REACHING IHA PAY FOR PERFORMANCE MEASURES
OAKLAND, Calif., February 14, 2007
– Seven California health plans paid a combined total of $55 million in 2006
to physician groups participating in the Integrated Healthcare Association’s
(IHA) “Pay for Performance” (P4P) program. The 2006 payouts, which topped
the previous year’s total payouts of $54 million, were made to physician
groups for performance measures gauging clinical care, patient satisfaction, and
the use of information technology during 2005.
Since IHA began measuring
performance in 2003, incentive payments to California physician groups have now
totaled approximately $145 million. Approximately
35,000 physicians in 210 groups are eligible for incentive payments under the
P4P program.
“Traditional approaches to
physician compensation don’t reward appropriate care, but California’s
pioneering P4P program realigns incentives.
It supports the need of physicians to have uniform performance measures
against which to gauge important indicators of quality, while also providing
consumers with valuable information to guide their choices,” said Donald J.
Rebhun, MD, regional medical director of HealthCare Partners and chairman
elect of IHA’s board of directors.
Motivated by the P4P program,
physician groups in 2005 reported screening about 60,000 more women for cervical
cancer, testing nearly 12,000 more diabetics, and administering approximately
30,000 more childhood immunizations than during the previous year for their
patients enrolled in participating health plans. Accountability and transparency
are cornerstones of the IHA P4P program, so physician group performance results,
including those of 17 Kaiser Permanente units, are publicly reported at
http://www.iha.org/p4prptcd.htm.
“As the largest and most
prominent P4P program in the country, IHA continues to provide a model to allow
competing health plans to cooperate on the use of standardized measures to help
physicians meet evidence-based quality performance targets to improve
healthcare,” said Curtis Terry, president, Health Care Delivery for Aetna’s
West region and an IHA board member. “California is leading the way by showing
that changing how we pay for health care can lead to quality improvements.”
Health plans participating in the
P4P program are Aetna, Blue Cross of California, Blue Shield of California,
CIGNA, Health Net of California, PacifiCare, and Western Health Advantage.
(Kaiser Permanente physician groups participate in public reporting only.)
In addition to the payments made to physician groups under the IHA
program, each health plan makes additional incentive payments to physician
groups based on plan-specific performance criteria. In 2006 these additional
payments totaled approximately $89.5 million. Details on the method used by each
health plan to calculate physician groups payments are contained in a Financial
Transparency Report available online.
IHA is a not-for-profit statewide collaborative leadership group of California health plans, physician groups, and health care systems, plus academic, consumer, purchaser, pharmaceutical and technology representatives that promotes quality improvement, accountability, and affordability for the benefit of all California consumers through special projects, policy innovation, and education. www.iha.org
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