Hospital and physician pay for performance initiatives are a potential multi-billion trend sweeping the nation as Medicare and insurers strive to increase healthcare quality and reduce costs.
In 2005, millions of dollars were paid to hospitals and physician groups in pay for performance bonuses. Numerous health plans have now launched their own version of hospital and physician pay for quality improvement incentives.
Is pay-for-performance just another "gimmick," a passing fad or payor "contrivance," that impacts on how hospitals and physicians get paid, or will the quality performance lessons learned reshape payor-provider dynamics?
No one can say for absolute certainty. That's why Pay-for-Performance Reporter is a valuable tool for you. It provides you with answers to questions you may have, with facts, news, insights and emerging hospital and physician P4P developments.
Pay-for-Performance Reporter will arrive in your e-mail inbox and in print on your desk every month with the latest news and information on physician incentives and key developments.
Carefully researched and compiled for you by the Managed Care Information Center editorial team, you can rely on the information in every issue of Pay-for-Performance Reporter. We have been covering and reporting on managed care since 1985 and the pay for performance emerging trend since 2002.
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“New Initiatives, Trends, And Results in Provider Pay-for-Performance," a new special report from MCIC, a $99 value
Hospital and Physician Pay-for-Performance News, Expansion and Trends
As quality concerns escalate and healthcare costs skyrocket, more healthcare pay for performance incentive reimbursement programs are being implemented by health plans around the country as a way to reward healthcare efficiency and effectiveness.
P4P focuses on both quality issues and patient satisfaction. But the quality in care is uppermost and zeros in on the deadly "quality gaps" that contribute to 42,000 to 79,000 avoidable deaths every year, based on National Committee For Quality Assurance (NCQA) figures.
Pay for performance physician initiative awards were up 25 percent last year, but some doctors are wary of the programs, according to two studies recently released. Most industry experts believe P4P programs will continue to grow and be embraced by health plans. For instance, BlueCross BlueShield Plans are offering physician pay-for-quality programs in 32 states and expect to implement programs in 14 additional states in the near future; Aetna, Cigna and HealthAmerica and HealthAssurance have also begun physician bonus incentive programs; and, Medicare launched a program to reward providers for the quality of care they deliver.
The Bridges to Excellence (BTE) Coalition launched a series of major physician pay-for-performance (P4P) initiatives involving the Medicare program, various business coalitions, a large national health plan and an important regional BlueCross Blue Shield plan. Together, the initiatives cover more than 10 states and 2 million people.
P4P is not a magic bullet, one new study cautioned, and there are many challenges to overcome for it to sustain its effect on the quality of healthcare, including whether it can work in all healthcare settings. For instance, one expert says hospital or physician performance award programs can be complicated to implement.
Pay-for-Performance Reporter: Insider Lessons and Developments
That's why it’s important to have in one place, carefully researched and documented for you the most important developments, news and insight you'll get with your monthly subscription to Pay-for-Performance Reporter.
In each issue, you’ll get:
- Insider lessons learned by early adopters of physician incentive bonus programs, executives, and physician leaders
- The latest from the organizations that have 'pioneered' exploration of physician and hospital Pay-for-Performance programs including the Integrated Healthcare Association (IHA), The Leapfrog Group, and such participating health plans as Aetna, Blue Cross, Blue Shield, CIGNA, Health Net, and PacifiCare
- News on the latest research like the study that showed significant quality improvements as a result of a physician pay-for-performance program by a large health plan
- Answers to your questions about physician P4P: Is there a "right way" to get physician buy-in? What makes for an effective outcomes-based physician incentive program? How is a "P4P" program implemented? What do health plans want in a provider performance quality program? What are the categories for physician incentives and hospital measures?
- Information from those involved in setting up and administering these physician incentive programs
- What's working in P4P
- Insight like how to deal with the top ten P4P pitfalls, or physician incentive examples and best practices
- Characteristics of successful incentive bonus programs to date and a preview of the next generation of provider incentive programs.
- Details on new quality of care and patient satisfaction programs
- Sources for assistance in setting up a P4P program
- Where P4P is headed in the years ahead
- Pro and cons from leading health organizations and stakeholders such as the National Business Coalition on Health, the American Medical Association, AARP, the American College of Physicians, and, The Alliance of Specialty Medicine
As a Charter Subscriber, you will receive the following benefits:
- Pay-for-Performance Reporter delivered to you in print and via email monthly
- Personalized news alerts – we will email you "breaking news"
- Results of exclusive reader surveys
- Exclusive research reports prepared by the MCIC editorial staff
- Access to an online discussion group where you can join with health and managed care executives as well as other professionals on issues and topics of P4P.
Subscribe today and discover how early adopters achieved physician "buy in," the importance of leverage, how to choose your performance incentive measures wisely and choose measures that are defensible, and why provider feedback is so important. Every month you'll receive an objective, balanced report with current news and findings surrounding P4P.
Plus, for a limited time, get a FREE bonus: “New Initiatives, Trends, And Results in Provider Pay-for-Performance," a $99 value with your paid subscription.