Program Results

Healthcare performance results released by IHA for measurement year (MY) 2009 include a comparison of average composite scores across the eight California regions in five performance measurement domains: clinical quality, coordinated diabetes care, patient experience, information technology-enabled systemness, and appropriate resource use.

2009 saw continued improvement on all but one P4P measure. Performance variation between top and bottom performers has continued to decrease, although there is still variation that is seemingly correlated with socioeconomic and geographic factors, as well as with use of health IT. Top performers in California are out-performing national HEDIS 90th percentile benchmarks on a number of measures.

California's P4P program has established a platform of trust which will be key to its future transformation into a value-based incentive program, where both high quality and efficient resource use will be rewarded. P4P has also helped to pave the way to broader payment reform in the state.

The brief on the 2009 P4P Program Results is available in the related resources section (to the right).   

Under the IHA P4P Program, measurement year results are used for three purposes: health plan incentive payments to physician organizations; public reporting of physician organization performance; and determination of P4P awards.

Health Plan Incentive Payments

Each health plan determines its own budget and methodology for calculating and distributing payments to physician organizations. Historically, most health plans made payments based on relative performance after physician organizations have met minimum thresholds. More recently, (pay for improvement) has become a feature of the payment methodology of most participating plans.


* Total payouts are for seven health plans using P4P results for incentive payments.
** Includes Kaiser Permanente Northern California starting in MY 2004. Includes Kaiser Permanente Southern California starting in MY 2005. Kaiser Permanente participates in public reporting only.

In 2010, the IHA P4P program entered its seventh reporting and payment year and eigth measurement year. Bonus payments by participating health plans in 2010 totaled about $49 million, which represents an average of about 1% of base income of each physician organization.

Public Report Cards

IHA partners with the California State Office of the Patient Advocate to produce an annual public report card of P4P results.

Public Report Cards

P4P Awards

Each year, IHA presents two sets of P4P awards: Top Performing Groups and Most Improved Groups.

P4P Awards