FRAMINGHAM, MA – Provider disconnects and inconsistent strategies are undermining U.S. pay-for-performance programs, a survey of healthcare payers reveals.
Results of the survey, by Health Industry Insights, an IDC company, are being challenged by some health plans.
Janice Young, program director of payer IT strategies for Health Industry Insights, said only one in three health plans responding to the survey provides financial incentives for IT adoption within their pay-for-performance programs.
The Integrated Healthcare Association, whose statewide California pay-for-performance program is one of the largest in the country and features a common set of measures and a public scorecard, said financial incentives for IT have been well-received by physician organizations.
Seven California health plans – Aetna, Blue Cross, Blue Shield, CIGNA, Health Net, PacifiCare and Western Health Advantage – offer financial and public recognition incentives.
“Some $55 million was paid out in financial incentives in 2006 ($145 million since the program’s inception), and $11 million of that amount was earmarked for IT adoption,” said Lauren Lempert, director of communications.
“The best performing physician groups in California are those who made the investment and embraced information technology,” said Donald Rebhun, MD, medical director of HealthCare Partners and chair-elect of the IHA. “In many cases, these IT investments would not have been possible without the financial bonuses earned through IHA’s pay-for-performance program.”
The number of physician groups earning full credit for IT adoption has increased 11 percentage points over last year, Lempert said.
“IHA’s pay-for-performance program has demonstrated a measurable correlation between IT adoption and clinical quality improvement,” she said. “Physician organizations that received full credit on IT measures had average clinical scores that were significantly higher than those that showed little or no evidence of IT adoption.”
“Aetna has a national pay-for-performance program that creates a base level of consistency in design, measurement use, reward structure and administration,” said spokesperson Karin Rush-Monroe. “Our framework of measures provides regionally based programs some flexibility to select from a standard set of measures to tailor the program to their delivery system.”
Rush-Monroe said Aetna’s pay-for-performance programs and measures continue to be refined as IT adoption increases among providers.