The Society of Thoracic Surgeons is involved in discussions with other payers after announcing a partnership with WellPoint to deliver performance data for WellPoint's pay-for-performance program in mid-July.
The formal relationship between payer and medical association is important as the professional group marks a new development in P4P programs, said Katy Henrickson, senior analyst for Forrester Research.
"P4P programs are often criticized for focusing on efficiency," she said. Support by the provider community will ensure that the focus is on quality of care.
WellPoint is working with the society, which is involved with the National Quality Forum and the American College of Cardiology, to help improve quality of cardiac care of its members.
"These societies have robust patient outcome data," said Kevin Barger, WellPoint's network development analyst lead. "It makes sense to combine the power of outcomes data with a pay-for-performance program for both our hospitals and physicians."
Robert Wynbrandt, executive director of the Society of Thoracic Surgeons, hopes the WellPoint partnership starts a trend that will_put the_focus on_clinical data_and not_just claims data. "It is extremely important for our members to tell a much fuller story," he said.
While including specialists with expertise that payers don't have, the society also stresses an engagement with providers and the resulting sense of trust.
"We don't just hand over data. We need consent of the participating entities in our database," he explained. "Trust is the bedrock of our own database."
Building on that trust, the society will work with its providers to raise their standard of quality rather than punish them for low marks. "We want to improve quality across the board," Wynbrandt said.
"Successful P4P programs out there focus on communication with the provider community," said Henrickson. She added that it makes sense for organizations representing large specialties with big patient populations to partner with payers, and she expects these partnerships to become more common in the future.
WellPoint is looking to expand its quality programs for other specialties in Virginia across its organization.
"We must work to ensure that performance measures are robust - especially for specialty care - are evidence-based, reflect national standards and are meaningful to consumers," Barger said.