The North Shore-Long Island Jewish Health System's Faculty Practice will participate in three pay-for-performance (P4P) agreements that will provide financial incentives and support of up to $3.6 million to help improve care quality, safety and patient satisfaction.
North Shore LIJ will participate in Aetna's P4P program, in which program measurements are defined as those embedded in the IHA model P4P, targeting clinical, member satisfaction and information technology.
"We think this is a good first step to partner with a payer to achieve higher quality of care," said Howard Gold, senior vice president of managed care and business development at North Shore-LIJ. "The key to good business arrangements between a payer and provider is to achieve better healthcare for our patients. We are pleased that Aetna recognized this as a way for our two organizations to work together."
The three agreements are:
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A ten-hospital P4P program specific to care delivered to Aetna members in their commercial products. The first year of this two-year agreement, which begins in 2009, will be a demonstration program. It involves incentives for the North Shore-LIJ hospitals to improve quality of care, efficiency and patient safety, (such as reporting to The Leapfrog Group on individual hospital performance).
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A second P4P program specific to the North Shore-LIJ Faculty Practice, treating members in Aetna's commercial, employer-sponsored or individual health benefits products. This three-year agreement provides incentives for clinical effectiveness, member experience and efficiency.
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And a third P4P program specific to the North Shore-LIJ Faculty Practice, treating members who have an Aetna Medicare plan. This program makes use of patient management staff from Aetna who will support the North Shore-LIJ care teams to help improve care quality for these patients and provide incentives to the faculty practice for providing and documenting follow-up and meeting quality targets.
"Working together to tailor opportunities for higher reimbursement around patient-centered improvements in care quality, safety and satisfaction is a shared goal between Aetna and North Shore-LIJ," said Glenn Pomerantz, MD, Aetna's northeast region medical director. "These multi-year agreements, which we have developed together, reflect our shared purpose of encouraging and rewarding the consistent use of the best practices in medical care."
The Health Research Institute at PricewaterhouseCoopers LLP, in its annual review of the top 10 concerns for health executives and policy makers, rated hospital performance at number seven on its list. In 2009, healthcare providers will have to get serious about not only improving performance but documenting it, the report said.