According to a new report, Arizona isn't embracing pay-for-performance programs as initially envisioned because the state's major insurer has failed to offer them. Analysts believe that will make it harder for the state to get the backing it needs for adoption.
HealthLeaders-Interstudy released the study, based on the latest Arizona Health Plan Analysis. The report found that although Blue Cross Blue Shield of Arizona does not offer employers P4P programs, several of the plan's major competitors have recently introduced programs to the market.
Last fall, UnitedHealthcare launched its P4P program, UnitedHealth Practice Rewards. The physician incentive program offers an enhanced fee schedule to physicians who meet defined criteria. Because the program has only been in place for several months, data is not available to determine how successful the program has been.
Aetna also offers a pay-for-performance program through the Bridges to Excellence coalition. Eligibility requirements for the program are that physicians must be in Aetna's Arizona network and have NCQA certification for the two tracks of the program, the Diabetes Care Link and the Cardiac Care Link. As part of the program, physicians must also meet clinical guidelines for treating diabetes, hypertension and cholesterol.
"Without the backing of the Arizona Blue plan, such programs will continue to be a tough sell in this market," says Heather Wicks, analyst for HealthLeaders-InterStudy and author of the report. "Support from area physicians has also been minimal as some do not see how pay-for-performance improves patient care."
Analysts believe that while pay-for-performance programs have evolved since their introduction five years ago, it's difficult to determine their overall worth. Many programs, they say, have offered financial incentives at the same time as other changes to improve quality, making it difficult to know if the extra money makes a difference.