Medica, a health insurance company headquartered in Minneapolis, has paid more than $3 million in the past year to providers in its network for improvements in clinical care provided to members.
Medica’s pay-for-performance program is designed to assess the efficiency and quality related to certain areas of clinical care. Its 2007 P4P program focused on asthma, Chlamydia screening, diabetes, generic drug prescribing, well-child examinations, childhood immunizations, mammography and Pap tests as well as participation in Medica’s high-tech imaging program.
“Medica’s pay-for-performance program demonstrates the high value we place on improving the care delivered to our members,” said Charles Fazio, MD, Medica’s chief medical officer. “It shows that when we focus on the right care at the right time and place we can achieve outcomes that are better for patients, have lower cost and stronger partnerships between Medica and our provider network. We are delighted to provide incentives when everyone benefits.”
Medica also rewarded providers for developing clinical practices that resulted in improved care and have evidence-based outcomes. Care improvement payments were made to providers through the Medica Raising the Bar Innovation Awards and Clinic-Based Chronic Care Management programs.
North Clinic, in Robbinsdale, Minn., was one of five clinic systems throughout Minnesota to participate in Medica’s clinic-based chronic care management program in 2007.
North Clinic developed a program around heart failure patients, identifying them through system-wide referrals from primary care providers and post-hospitalization diagnoses. The clinic developed a registry to monitor clinical status and track process and outcome measures. Clinic staff were encouraged to use evidence-based treatment plans for patients with heart failure and provide care coordination between the clinic and hospital.
"We are extremely pleased to participate in this chronic-care management program with Medica," said Cynthia Weisz, the medical director at North Clinic. "As providers on the front lines of care, we believe we are in the best position to help patients with these diseases make improvements to their health. The program also supports the concept of a medical home, which North Clinic believes is very important to the ongoing care of its patients."
