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Home / News & IndustryManaged Care Insight and Analysis
Updated: November 3, 2009
IHA P4P Program Unites California Health Care Fractions

Largest Non-Government Physician Incentive Program In U.S.

Bringing together the different and competing health industry groups in California is the most notableaccomplishment for the state’s young P4P program, an industry executive said.

It’s a "major achievement," said Dr. Michael Belman, medical director, quality and innovation for Anthem Blue Cross of California. Large health plans, medical groups, the National Committee on Quality Assurance (NCQA) and the Pacific Business Group on Health working together produced "a statewide state-of-the-art quality report card based on best of class features."

Program findings are in "The Second Chapter," a white paper published by The Integrated Healthcare Association (IHA), a statewide leadership group, promoting quality improvement, accountability and affordability of healthcare in the state.

"The Second Chapter" chronicles the program’s evolution, performance results, successes, lessons learned and future opportunities for growth and change.

It also said that the P4P program has not fully achieved its goal to create performance breakthroughs in clinical outcomes or patient experiences.

The program has been challenged by small incentive payments, equaling less than 2 percent total compensation. By contrast, 25 percent of a primary care physician’s income in England is dependent upon performance, resulting in significant quality improvements, said Chris Ham, professor of health policy and management at the University of Birmingham in Great Britain.

A recent MedVantage survey found that in the United States P4P payments average 7.25 percent of physician compensation.

The IHA P4P includes eight health plans and more than 200 medical groups, representing 35,000 physicians caring for 11.5 million HMO members. This makes the program the largest non-government physician incentive program in the nation.

In addition to the new collaborative environment, the program can point to other successes including creation of a single performance-based set of measures and public report card, considered a major step forward in performance measurement; and the aggregation of data from multiple payers for calculating scores, which has increased reliability and trust.

Program advocates said IHA’s P4P program has helped to dispel the myth that it is impossible to measure quality in healthcare. Ultimately, the California experience demonstrates that P4P is not itself the answer, but that it is an important step toward accountability, continuous quality improvement and effective payment reform in healthcare.

Address: Integrated Healthcare Association, 300 Lakeside Drive, Suite 1975, Oakland, CA 94612; (510) 208-1740,

  This article was taken from:
The Executive Report on Managed Care

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