Value Based Pay for Performance 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 through performance measurement for accountability and performance improvement. Program participants include 10 health plans and more than 200 California physician organizations caring for over 9 million Californians enrolled in commercial health maintenance organization (HMO) and point of service (POS) products. Annual quality, patient experience, and total cost of care results are analyzed and shared with program stakeholders and the public.
IHA supports public reporting of performance results and partners with the California Office of the Patient Advocate (OPA) to publicly report VBP4P quality, patient experience, and total cost of care 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. 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.