P4P — giving rewards at the practice level














Simply implementing a pay-for-performance program isn't enough to result in sustainable improvements in quality of care, according to a study in Archives of Pediatric and Adolescent Medicine. A physician-hospital organization (PHO) launched an asthma care collaborative — primary care practices that work together to reduce asthma-related emergency department visits, hospital admissions, and missed workdays and schooldays — with more than 13,000 children in 44 primary care practices (165 physicians). The PHO approached Anthem Blue Cross and Blue Shield of Ohio to fund for a program that rewarded, at the network and practice levels, measured improvements in asthma care. The program consisted of three reward levels, with practices having the potential to earn up to a 7-percent increase in fees.

Distribution of rewards

The asthma care collaborative engaged all levels of practice staff. Rewards went to the practice; physician-level incentives were not included. Rewards were earned by 43 practices: three practices earned only a 2 percent increase; 13 achieved a 4 percent increase; 2 received a 5 percent increase; 14 had an increase of 6 percent; and 11 were able to gain a 7 percent increase or bonus.

Source: Mandel KE, et al. Pay for performance alone cannot drive quality. 2007. Arch Pediatr Adolesc Med;161(7):650­655.

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HAP, a subsidiary of Henry Ford Health System, is a nonprofit health plan providing coverage to individuals, companies and organizations. This executive develops strategies to meet membership and revenue targets through products, pricing, market segmentation and advertising.  Aligns business among Business Development, Commercial Sales, Medicare and Public Sector Programs and Product Development. Seeks to enhance and be responsible for business development and expansion through the development of an effective product portfolio, strong interpersonal relationships and service excellence.

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