Audio CD and written materials of AIS's audioconference on October 28, 2004

Health Plan Strategies for Developing Physician Pay-for-Performance Programs

Find out how to design and implement pay-for-performance programs that will fully engage physician partners, align financial incentives and bring about lasting improvements in the quality of health care.

Sponsored by AIS's Managed Care Week.

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With heightened focus on health insurance premiums and the quality of care provided to enrollees, more and more managed care plans are developing pay-for-performance programs. Key to the success of these initiatives is buy-in from participating physicians and medical groups.

To develop an effective pay-for-performance (P4P) program, many insurers solicit and incorporate feedback from physician groups on every aspect of the program, from the size and timing of rewards to the types of measures used and how they are reported.

Hear executives from HealthPartners, Inc. and HealthCare Partners Medical Group — which are not affiliated organizations — describe their participation in P4P programs.

Minneapolis-based health plan HealthPartners started reporting clinical results to medical groups in 1994 and expanded that initiative to a P4P program in 1996. Today, the 660,000-member health plan has P4P programs underway for primary care physicians, specialists and hospitals. It uses the measurement results to support a tiered-network product.

Torrance, Calif.-based HealthCare Partners Medical Group has more than 360 physicians and specialists at 28 medical offices and four urgent care centers throughout Los Angeles County. The medical group actively participates in P4P programs, and its executives serve on the steering and technical committees of the Integrated Healthcare Assn.'s P4P program. It also has drawn extensive financial compensation and other recognition for its participation in P4P programs. HealthCare Partners was the top-rated medical group in California according to the 2002 Consumer Assessment Survey of patient satisfaction rates, and received a 98th percentile ranking in PacifiCare Health Systems, Inc.'s fall 2002 Quality Index Profile.

Find out:

 

Speakers

BABETTE APLAND is senior vice president of health management, care management and provider relations for HealthPartners. In this role, she provides leadership for health improvement, disease prevention, disease and case management, quality improvement and medical policy. Her responsibilities include oversight of HealthPartners' contracted network, which involves managing contracted relationships with more than 4,200 primary care physicians in over 700 clinics, 9,700 specialty physicians and 164 hospitals. Prior to joining HealthPartners, Ms. Apland was a health care consultant focusing on strategic planning for hospital and clinical care systems. She also served previously as vice president of Mount Sinai Hospital in Minneapolis, where she was responsible for ancillary and support services, and was executive director of the Phillips Eye Institute in south Minneapolis. Ms. Apland holds an M.B.A. degree in finance and a master's degree in speech pathology.

WILLIAM CHIN, M.D., is executive medical director for HealthCare Partners Medical Group. As executive medical director, he is accountable for the clinical outcomes and costs attached to the outcomes achieved by the medical group. HealthCare Partners has 30 sites and over 300 full-time physicians. Chin previously was president of Huntington Medical Group, Inc. and a former chairman of the Unified Medical Group Assn. He attended Rensselaer Polytechnic Institute and the University of Buffalo Medical School. He is certified in internal medicine and rheumatology.

Moderator: Jill Brown, managing editor, Managed Care Week.

 

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