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MANAGED CARE EXECUTIVE EDITION December 2002. ©MediMedia USA
NEWS AND COMMENTARY
Paying quality bonuses: Idea that's catching on
Paying bonuses to physicians for providing quality care is a concept whose time apparently has arrived.
Efforts are already underway in at least two states, California and Massachusetts, and one employer coalition admits that it finds the idea intriguing.
In Massachusetts, Harvard Pilgrim will pay Partners HealthCare bonuses if Partners improves the care of diabetics and asthmatics.
"The new approach grows out of a recognition that the reduction in health cost inflation achieved by managed care in the 1990s is a thing of the past and new tools are needed to keep costs from skyrocketing as the population ages," the Boston Globe intones in an editorial. "The resistance of both the public and doctors to HMO cost-cutting measures that limit choice and access puts a premium on 'carrot' incentives like $100-per-year bonuses for each diabetes patient treated according to American Diabetes Association standards."
Meanwhile, health plans in California recently issued criteria for a program under which they'll also pay for high-quality care.
Payments to physician groups, expected to begin next year, will be based on three categories: clinical quality, patient satisfaction, and investment in information technology.
Six health plans will participate in the $100 million incentive plan, called "Pay for Performance." They are: Aetna, Blue Cross of California, Cigna Healthcare of California, Health Net, and PacifiCare.
The program is being coordinated by the Integrated Healthcare Association.
"With a single set of performance measures, physician groups will no longer be forced to comply with the conflicting demands of six different health plans," Steve McDermott, chief executive officer of Hill Physicians Group and an IHA official, tells Health Care Policy Report. "By alleviating this burden, we're able to focus on helping physicians provide the best care possible."
The Washington Business Group on Health tells Managed Care magazine that it just makes sense to pay more to providers who show good data on quality.
If that's not enough, the government is also interested. There's a new initiative to pay for quality in the Medicare and Medicaid programs.
There are high hopes about where this is going. "All health care providers will see their reimbursements by both insurers and the federal government increase over time," the Globe editorial points out. "The experiments under way in Massachusetts (and some other states) should show whether tying increases to higher quality will both benefit patients and, ultimately, reduce health care costs."