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Home > Managed Care
Pay for Performance: Millions of Dollars in Physician Bonus Incentives Linked to Improving Quality of Care
Pay for Performance: Millions of Dollars in Physician Bonus Incentives Linked to Improving Quality of Care
Pay for Performance: Millions of Dollars in Physician Bonus Incentives Linked to Improving Quality of Care
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Innovative health plans are ready to put an estimated $100 million on the table to award physicians for improving quality and care and patient satisfaction. Among the plans embracing this dramatic, emerging industry trend are Blue Cross of California, Health Net, Blue Cross of Michigan, and Aetna.

This highly rated management briefing on CD-ROM provides details and insight into how this new trend will affect MCOs, employers and health plan members.

The 90-minute program comes with complete conference materials including slides, charts, program descriptions, examples, program measures and incentive bonus best practices.

You can use the program for management awareness training or for planning implementation procedures.

Here’s what participants in the live conference said:

"Learned a great deal, easy way to learn while having lunch at my desk." Jenny McGee, VP, HealthShare Technology, Inc.;

"Very complete," VP strategic marketing technology company;

"Great thought about what may motivate physicians to take desired action as well as the magnitude of the payments needed to make a difference," Howard Shaver, Consultant, The Rogoff Firm;

"Combination of: a) survey use/results and b) real world examples;"

"Having experts & experience ‘this is how we did it’;"

"Speakers were on point;"

"Balance of high level concepts with front-line experience;"

"The advice about what might be done differently as well as the lessons learned. Also liked the discussion about measures for both PCPs and specialists;"

Physician incentives just may be the secret ingredient that health plans have been seeking to strengthen quality measures, improve outcomes, and increase patient and member satisfaction. Some $28 million in physician bonus incentives was paid out to 80 participating physician groups by Blue Cross of California, Thousand Oaks, Calif., on the basis of using the new quality scorecard.

Pay for Performance (P4P) was developed to reward those physician organizations that excel in meeting selected quality criteria; according to the Integrated Healthcare Association (IHA) Walnut Creek, which launched the program with Aetna, Blue Cross of California, Blue Shield of California, CIGNA, HealthNew and PacifiCare.

Rather than monitoring physician groups on the basis of traditional cost controls and utilization management, Pay for Performance (P4P), the revised bonus evaluation process, monitors for improving the quality of care given to HMO patients using health outcomes and patient satisfaction information from a number of clinical and service categories, according to the Blue Cross of California.

IHA estimates that up to $100 million or more could be paid out to physician groups in the first year based on the performance results.


  • Overview of currently available physician incentive programs
  • What's working today
  • Characteristics of successful programs
  • Details on new quality of care and patient satisfaction programs
  • Sources for assistance in setting up a P4P program
  • Where P4P is headed
  • Why many physician organizations and health providers are embracing pay for performance.
  • How a P4P program is implemented.
  • The market and design conditions conducive to a successful P4P
  • Incentive targets and categories for physician incentives and hospital measures

Clearly this rapidly emerging development has the potential to raise the bar for benchmark measure levels. Learn more about this quality initiative with the CD-ROM of the audio conference: "How Millions of Dollars in Physician bonus Incentives Linked to Improving Quality of Care May Be The Answer for Managed Care" and learn how you and your organization could participate in and benefit from Pay for Performance programs. This audio conference features two of the nation’s leading authorities on provider pay for performance.

Beau Carter is the Health Policy and Strategy Consultant for Med-Vantage, Inc., but also served as the first Executive Director of the Integrated Healthcare Association (IHA) at the time Pay for Performance (P4P), the largest quality initiative in the nation, was launched.

Mr. Carter provides a review of P4P programs by product type, by incentive target, cover the categories for physician incentives; physician measures and examples; and categories of hospital measures, examples, weighting examples, and go over provider incentive pay-out approaches; and funding levels.

Dr. Jeff Kamil, vice president and corporate medical director for WellPoint's Blue Cross of California, was also involved with Mr. Carter in the initial roll-out of P4P with the IHA.

Dr.Kamil discusses quality bonus history and the background of P4P; provide incentive examples; review the quality score care/best practices and what is measured; compare the care categories and quality of care received; discuss economic benefits; and, timing considerations

He also looks at plan-wide results and the HMO bottom line; reviews the distribution of eligible physicians and 2004 payments; then covers the next steps and the next generation of incentive programs.


Health plans and providers, CEOs, CFOs, employers, human resource benefit managers, medical directors, sales and marketing executives, employer health plan decision makers, network development and provider services directors, strategic planners, utilization management, MCO plans, healthcare management, brokers, TPAs, network managers, physician practice management company executives, medical management directors, PHO and IPA leadership, analysts, implementer consultants, account services and administration executives and ancillary products managers.

Discover more about this quality initiative. Get the CD-ROM recording of this senior level executive audio conference: "How Millions of Dollars in Physician Bonus Incentives Linked to Improving Quality of Care May Be The Answer for Managed Care".

Publication Date: 2004
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