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Wednesday April 19, 2006
Case Study from Rochester IPA
- Securing a 4:1 ROI against medical trend for diabetes and CAD through the development of an innovative gainsharing model
- Engaging both generalists and specialists in reducing overuse and misuse to create a balanced portfolio of P4P measures
- Creating shared office reminder to align patient and physician goals
- Incentives for office staff for P4P outcomes: Creating organization wide commitment
Case Study from Priority Health
- Driving performance improvement through strategic alignment of economic incentives, transparency, and decision support tools
- Key features of an 8 year pay-for-performance program for quality measures
- Data to demonstrate how improvement rate doubled to approach 90th percentile for national HEDIS standards
- Funding the PCP incentive pool to 20-30% of total compensation
- PCP and specialists’ pay for improvement program (generic use, inpatient days, and more recently high tech radiology use and ER use)
- Alignment of consumer and provider incentives for generic drug use saving over $30M in 2 years
Case Study from HealthPartners - Transforming Health Care Using Composite Measures, Collaboration, Pay for Performance and Public Reporting
- High impact measures - Using clinically relevant, composite performance measures for PCPs and specialists (i.e. cardiology, behvaioral health and neurology) to engage providers to improve systems and implement team-based care
- Aligning incentives - Developing pay for performance programs for retail pharmacists, physical therapists and behavioral health clinicians
- Public reporting - Increasing the impact of reporting provider quality through regional health plan, purchaser and provider collaboration
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