performance program

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 …

Throwing fuel into the CDHP fire, WellPoint announced that it will make all of its CDHP products available in all markets to both employers and individuals beginning on January 1, 2007. Execs say that consumer interest in CDHPs led the insurer to make the plans more accessible and estimates that it could save patients up to $400 dollars a year over traditional plans. "More informed consumers can make better health care decisions and improve their health, which can help to …

The $66 million dollar question: How to make pay for performance work
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, which recently awarded its contracted medical groups $66 million in incentive pay.
How long has your current pay for performance program been in the works?
First, bear in mind that 99 percent of our HMO network is through our delegated medical groups.  We give the group a full capitation for the professional risk, though the hospital risk stays with us.
Anyway, we had a program in the 90s aimed at our HMO product which offered a small incentive related to how doctors managed chronic disease, health, and how they managed grievances and appeals.  But the money wasn’t very much.

Blue Cross of California is paying 178 physician groups an extra $65 million this year under a pay-for-performance program that rewards high quality in a number of areas, including patient satisfaction, waiting times for appointments, number of complaints and grievances, and review of medical group or IPA functions. Performance in clinical areas was tracked, too, including managing chronic diseases such as asthma and diabetes and adherence to screening guidelines for breast and cervical …

Minnesota governor Tim Pawlenty has instituted a pay-for-performance program for all state-paid healthcare plans, including the state's medical assistance programs for the poor and the health plans for state workers. The program will set standards for quality of care in four of the most expensive areas: diabetes, hospital stays, preventive care and cardiac care. In each area, it will set targets for healthcare providers and pay bonuses to those who increase quality and performance. The …

A new proposal would expand the nation's largest pay for performance plan to reward doctors who do better in patient satisfaction surveys and quality reviews. The California Pay for Performance Program was launched five years ago by a consortium of employers, health plans and physician groups. About half of the physician groups in California have signed up to participate in the program so far, the Los Angeles Times reports. Under the group's latest proposal, bonuses would …