The Integrated Healthcare Association, a statewide leadership group that promotes quality improvement, accountability and affordability of healthcare in California, announced Thursday the 2007 pay-for-performance program results and performance award winners.
According to the results, clinical quality and information technology showed improvement, but patient experience scores - though remaining stable - lacked improvement.
The 2007 measurement year results were used by seven health plans - Aetna, Anthem Blue Cross, Blue Shield of California, CIGNA HealthCare, Health Net of California, Western Health Advantage and UnitedHealthcare - to calculate incentive payments for distribution to physician groups in 2008. Health plans have already distributed more than $212 million in payments to physician groups as a result of meeting P4P quality measures from 2003 through 2006.
Each health plan develops its own formula to determine payments based on their physician group's performance in relation to clinical quality and patient experience measures and adoption of IT.
"The IHA pay-for-performance program is a vital part of California health plans' partnerships with physician groups as we jointly strive to improve the quality of care available to individuals," said Steven Halpern, MD, senior medical director for CIGNA HealthCare. "We are pleased that so many medical groups have embraced P4P in recent years and are using it as a foundation for implementing systems that continually enhance care. We congratulate the medical groups that have demonstrated such high levels of performance and improvement over the past year."
IHA presented two sets of performance awards to California physician groups. The first set of awards recognized 46 physician groups with the best overall performance on important healthcare quality measures, including preventive care and chronic care management, patient satisfaction and use of IT to support safer care. The second set of awards recognized 11 physician groups who demonstrated the most overall quality improvement in their region on these same measures.
Top performing physician groups scored in the top 20 percent of participating groups on performance measures that include clinical quality measures (cancer screenings, immunizations, diabetes care, etc.), patient satisfaction measures (timely access to care, doctor-patient communication, etc.) and use of HIT that includes supporting clinical decision-making and use of systems to assure patients receive evidence-based care.
"Consumers and purchasers of healthcare in California expect their providers to continually improve the quality and affordability of care provided," said Don Crane, CEO of the California Association of Physician Groups. "These top performing physician groups are outstanding examples of what organized physician groups can do as they implement policies and practices designed to produce better care and greater value for healthcare dollars."
IHA also recognized 11 physician groups with the "Ronald P. Bangasser Memorial Award for Quality Improvement" for showing the most significant improvement on P4P measures from 2006 to 2007.
Scores for each participating physician group reflecting 2007 performance on P4P measures will be posted on the California Office of Patient Advocate Web site in November.