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Exclusive: How to make P4P work
In a Web exclusive, Dr. Michael Belman, staff VP and Medical Director with WellPoint division Blue Cross of California, discusses how his company developed its pay-for-performance program. Dr. Belman says that the P4P program came about as Blue Cross realized that it could do more to manage chronic disease, improve care and cut costs. The insurer worked with the Integrated Healthcare Association to develop a report card based on HEDIS measures. The report card, which is also used by a number of other health plans, "weighs clinical quality at 50 percent, patient experience at 30 percent and information technology at 20 percent." Dr. Belman says that the most successful groups have several things in common: a solid health IT system, a program to actively work with non-compliant patients and a registry for patients with common medical problems such as diabetes and heart disease. Overall, Blue Cross of California has doled out $66 million in incentive pay to its contracted medical groups.
To learn more about the P4P program:
- read this exclusive interview on FierceHealthcare.com
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