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California Pays $65M for P4P

February 28, 2008
by root
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Pay for performance (P4P) bonus payouts from health plans to California physician groups to reward quality of patient care totaled $65 million in 2007, according to Oakland, Calif.-based Integrated Healthcare Association (IHA). The nonprofit group says payments were distributed during the third and fourth quarters of 2007 based upon the 2006 performance of physician groups serving seven HMO members.

Aetna, Blue Cross of California, Blue Shield of California, CIGNA HealthCare, Health Net, PacifiCare, and Western Health Advantage participated in the performance payments with each health plan determining its own budget and methodology for calculating bonus payments to the physician groups, IHA says.

According to IHA, payments are typically paid on how well a physician group performs versus its peers, but emphasis is also placed on groups that show significant improvement over prior years. Participating health plans have been encouraged to allocate 20 percent of 2008 bonus payments for physician groups that make the most significant improvements.

Another incentive to promote improved physician group performance involves public reporting of results. Annually the results for each performance measure are reported by physician group on a Web site managed by the California Office of the Patient Advocate. The site provides consumers a comparison of physician group performance by county.

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