MGMA: MI group wins at pay-for-performance

Today, everyone's wondering how to make pay-for-performance worth their trouble. For one Michigan medical group, managing a pay-for-performance incentive program successfully is calling for a mix high-tech skills and old-fashioned process changes. IHA of Ann Arbor [1], a 130-physician group with more than 248,000 patients and 27 office locations, has been involved with P4P incentives offered by Blue Cross Blue Shield of Michigan for several years, according to Carlotta Gabard, MBA, DPH, vice president for administrative services. Gabard, who spoke at the Medical Group Management Association's Annual conference, says that over time, IHA has done very well with the BCBS program, generally receiving 85 percent to 90 percent of the bonus offered.

In building its P4P efforts, IHA has focused on a few key areas of concern, including chronic illness care, developing cost-effective prescribing patterns and increasing electronic information access. Health IT has been critical to addressing some gaps. For example, the firm used its practice management system to identify patients with relevant diagnoses, then used these profiles to build practice-wide disease registries. Nurses use the registries to monitor patients and schedule necessary preventive care for patients. IT staff also produce reports on how each individual office is performing by patient population and disease category, as well as by individual provider. 

Even without adding an electronic medical record into the mix--and one is on the way--the practice had to take the costly step of boosting its IT staff from six to 15 members just to support the added technology infrastructure. Fortunately, however, not all changes IHA made to support its P4P objectives required big investments. For example, IHA boosted generic drug prescriptions by printing up prescription pads which featured easy-to-use lists of high-volume generics.

To learn more about IHA:
- visit its Web site [1]

Related articles:
NY health plans launching physician P4P project. Report [2]
Trend: Number of P4P programs increasing rapidly. Report [3]
Study: P4P definitions, incentives still 'incomplete.' Report [4]
Physicians question CMS P4P effort. Report [5]
CMS extends pay-for-performance program. Report [6]
Health IT not playing key role in P4P. Report [7]
Trend: Medicaid programs offer P4P incentives. Report [8]
Exclusive: How to make P4P work. Interview [9]