|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
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, www.iha.org.