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Home / News & IndustryManaged Care Insight and Analysis
Updated: March 2, 2010
California Blue Puts Its Money Where Its Mouth Is

Blue Shield of California continues to walk the walk, paying out $29.6 million in bonuses to medical groups and IPAs in California, based on performance.

The money rewarded those medical groups and IPAs for high achievement and improvement are in areas that Blues’ members care the most about – key clinical and patient experience metrics.

Since the launch of its P4P program in 2003, Blue Shield of California has awarded more than $78 million to providers. They said their program has improved the health of its members, such as increasing Chlamydia screenings by nearly 50 percent, HbA1c control for diabetic patients by 64.4 percent, and colorectal cancer screenings by 53 percent.

The money reinforces the Blues commitment to access and high quality care, said Juan Davila, senior vice president of network management for the Blues. "Participating in the pay-for-performance program allows us to encourage best practices from physicians, control the rising cost of healthcare, and ensure members receive access to the care they need," he added.

The largest portion of the money – $12.5 million – went to the Integrated Healthcare Association’s (IHA) P4P program.

Another $9.6 million was awarded under Blue Shield’s Performance Improvement Rewards Program, which recognizes and rewards medical groups and IPAs for effectively managing emergency room visits, outpatient surgeries, inpatient bed days and generic drug utilization. The remaining $7.5 million was awarded for shared savings and other incentive programs

Blue Shield of California is also working with those medical groups that fell below average in their clinical scores to help them improve their performance.

For more information on Blue Shield of California, visit www.blueshieldca.com.


  This article was taken from:
Pay-For-Performance Reporter

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