The Integrated Healthcare Association (IHA), a statewide leadership group that promotes quality improvement, accountability and affordability of healthcare in California, has named its top 45 performing physician organizations for 2009, based on the IHA statewide Pay for Performance (P4P) program measures.
IHA also presented awards to seven physician organizations within each P4P region that demonstrated the most quality improvement from 2008 to 2009
The top 45 organizations were named from a total list of 221 physician organizations in California. Both top performer and most-improved awards are based on performance in four P4P measurement domains: clinical quality, patient experience, information technology-enabled systemness and coordinated diabetes care.
“P4P program results for measurement year 2009, the seventh year of the P4P program, showed continued modest improvement in most clinical measures compared to the prior year,” said Cindy Ernst, director communications, IHA.
“Patient experience scores also showed a slight upward movement across all measures," she added. "Adoption of most IT activities continued to increase, and more than two-thirds of physician groups demonstrated some health IT capability."
Hill Physicians Medical Group in the Bay Region was the only physician organization to achieve both the top performer and most-improved awards for 2009.
"We're very pleased the hard work that goes on behind the scenes has a demonstrable effect on quality of care and overall member experience," says Steve McDermott, chief executive officer, Hill Physicians Medical Group. "Our focus on timely, personalized care supported by technology and best practices is the right thing to do for the individual member, for the physician and for the overall health of the communities we serve."
Hill Physicians has received only about half of the health plans’ payments thus far, says Dan Robinson, chief administrative officer, PriMed Management Consulting Services, Hill Physicians. “Assuming we have budgeted correctly and based on what we have received to date we expect to receive between $3.8 million and $4.0 million,” he said.
Demonstrating the positive impact of the P4P program, Arch Health Partners of San Diego moved from being one of the most improved last year, to being a top performer this year. Based on its scores, Arch Health Partners will receive $260,000 for its performance.
"Our vision focuses on coordinating quality medical care for our patients at all levels," said Stuart Graham, MD, a pediatrician and a board member of Arch Health Partners. "At each opportunity, we emphasize education, prevention and patient satisfaction. We believe in personal relationship as the beginning of quality care and we empower our team to work with patients to individualize care for their needs."
The top performing physician organizations were identified by calculating a score in each of the four P4P measurement domains, which are then weighted to compute an overall composite score.
In addition to being used for determining awards, the 2009 measurement year results are used by seven health plans – Aetna, Anthem Blue Cross, Blue Shield of California, CIGNA HealthCare of California, Health Net of California, Western Health Advantage, and UnitedHealthcare – to calculate incentive payments for distribution to physician groups in 2010. Health plan incentive payments paid in 2009 were $52 million to physician organizations as a result of meeting P4P measurement criteria for clinical quality, patient experience, and information technology-enabled systemness. Each health plan develops its own formula to determine payments, taking into consideration recommendations from the IHA P4P Steering Committee. Payouts for 2009 are distributed during the fall of 2010.
