|Aetna And North Shore-Long Island Jewish Enter Into Three P4P Agreements
Aetna and the North Shore-Long Island Jewish (North
Shore LIJ) Health System’s Faculty Practice have entered into
three pay-for-performance (P4P) agreements which will provide financial
incentives and support totaling more than $3.6 million to help the
North Shore-LIJ hospitals and Faculty Practice improve care quality,
safety and patient satisfaction.
The selected measures are intended to achieve the following objectives:
- Member care that is effective and efficient;
- Member care that meets clinical quality standards and results in quality of care and outcome improvements for members; and
- Care practices that promote patient safety.
The three agreements, which provide an opportunity to earn a total of $3.6 million, include the following components:
1.) A ten-hospital P4P program that is specific to care
delivered to Aetna members in our commercial products. The first year
of this two-year agreement, which began this year, will be a
demonstration program. It involves incentives for the North Shore-LIJ
hospitals to improve:
Quality of Care, such as assuring surgical patients receive prophylactic antibiotics prior to surgical incision;
Efficiency, such as reducing hospital readmissions for the same injury or illness; and
Patient Safety, such as reporting to The Leapfrog Group on individual hospital performance.
2.) A second P4P program that is specific to the North
Shore-LIJ Faculty Practice treating members within Aetna’s
commercial, employer-sponsored or individual health benefits products.
This three-year agreement provides incentives for:
Clinical effectiveness, such as increasing
screening rates for breast, cervical and colorectal cancer as well as
improvement in specified diabetes screening and management measures;
Member Experience, such as maintaining 100% access to all primary care physicians for new Aetna patients; and
Efficiency, such as improving compliance levels with Aetna’s drug formulary.
3.) The third P4P program is specific to the North
Shore-LIJ Faculty Practice treating members who have an Aetna Medicare
plan. This program includes dedicated patient management staff from
Aetna who will support the North Shore-LIJ care teams to help improve
care quality for these patients, and provide incentives to the Faculty
Providing and documenting follow-up care for seniors with chronic medical conditions as outlined by the government’s risk adjustment system; and
Meeting quality targets, such as assuring follow-up care at the doctor’s office soon after going home after a hospital stay.
Addresses: Aetna Inc., 151 Farmington Ave., Hartford, CT 06156; (860) 273-0123, www.aetna.com. North Shore Long Island Jewish Health System, 26901 76th Ave., New Hyde Park, NY 11040; (718) 470-3000, www.nslij.com.