Wednesday, October 28, 2009
Blue Shield of California has rewarded $29.6 million in so-called pay for performance bonuses to California medical groups and IPAs this year, based on key clinical and patient experience measurements.
The largest section of the P4P payouts -- 42 percent or $12.5 million -- is linked to the Integrated Health care Associations statewide P4P program, which provides a framework for health insurers, including Blue Shield, to reward medical groups for quality on metrics such as clinical care, diabetes care, patient experience and use of health-care information technology.
This year, an additional $9.6 million is being rewarded under Blue Shields own Performance Improvement Rewards Program, which rewards medical groups and IPAs for managing ER visits, outpatient surgeries, inpatient bed days, and generic drug use. The remaining $7.5 million of 2009s $29.6 million total went to related shared savings and incentive programs with contracting physician groups and IPAs, or individual practice associations, which link small medical practices for contracting and related business purposes.
Blue Shield also whispered it will reach out to medical groups with less than stellar clinical performance to help them boost their scores, by offering tips and providing information about additional resources.
Last month, the IHA noted that along with determining awards through its program, P4P data is used by seven California health insurers -- Blue Shield, Aetna, Anthem Blue Cross, CIGNA Health Care of California, Health Net of California, and United Health care to calculate incentive payments to participating medical groups and IPAs.
IHA says Californians voluntary P4P program is the nations largest non-governmental physician incentive program, and includes eight participating health insurers (including Kaiser Permanente for reporting purposes only) and more than 225 medical organizations representing 35,000 physicians.
The largest section of the P4P payouts -- 42 percent or $12.5 million -- is linked to the Integrated Health care Associations statewide P4P program, which provides a framework for health insurers, including Blue Shield, to reward medical groups for quality on metrics such as clinical care, diabetes care, patient experience and use of health-care information technology.
This year, an additional $9.6 million is being rewarded under Blue Shields own Performance Improvement Rewards Program, which rewards medical groups and IPAs for managing ER visits, outpatient surgeries, inpatient bed days, and generic drug use. The remaining $7.5 million of 2009s $29.6 million total went to related shared savings and incentive programs with contracting physician groups and IPAs, or individual practice associations, which link small medical practices for contracting and related business purposes.
Blue Shield also whispered it will reach out to medical groups with less than stellar clinical performance to help them boost their scores, by offering tips and providing information about additional resources.
Last month, the IHA noted that along with determining awards through its program, P4P data is used by seven California health insurers -- Blue Shield, Aetna, Anthem Blue Cross, CIGNA Health Care of California, Health Net of California, and United Health care to calculate incentive payments to participating medical groups and IPAs.
IHA says Californians voluntary P4P program is the nations largest non-governmental physician incentive program, and includes eight participating health insurers (including Kaiser Permanente for reporting purposes only) and more than 225 medical organizations representing 35,000 physicians.
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