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Home / News & IndustryManaged Care Insight and Analysis
Updated: September 29, 2009
AHIP Promotes Private-Sector Solutions For Healthcare Reform: New Health Plan Payment Models

As Congress considers various proposals to reform our healthcare system, America's Health Insurance Plans (AHIP) is encouraging policymakers to consider the next generation of delivery system reform currently underway in the private market.

"Health plans are piloting new payment models that are making the system more affordable and improving value and quality," said Lewis Sandy, MD, Senior Vice President of Clinical Advancement at UnitedHealth Group.

At least half of the nation's health plans include some pay-for-performance incentives in their provider contracts, according to a 2006 New England Journal of Medicine.

AHIP hoped to report measurable results from health plan payment models that have shown promising results and innovative approaches.

AHIP cited the measurable results that P4P programs have achieved are:

  • Better adherence to evidence-based treatment guidelines for patients with chronic conditions
  • More patients getting recommended treatment post-hospitalization
  • Reduction in emergency room visits
  • Increased generic prescribing rate
  • Greater adoption of new technologies
  • Increased adherence to recommended preventive screenings and vaccinations
  • Overall enhanced patient satisfaction

"There is still a wide variation across the country in how physicians practice and what care they give, and, as a result, research shows that Americans continue to spend significant healthcare resources on inappropriate and unnecessary care," said Steven Udvarhelyi, MD, Senior Vice President and CMO at Independence Blue Cross.

Address: America's Health Insurance Plans, 601 Pennsylvania Avenue, NW South Building, Suite 500, Washington, DC 20004; (202) 778-3200,

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

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