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Health Plan Pay-for-Performance Programs: The Next Generation

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Price: $124
Pages: 54

PDF Version: 1,007 KB

ISBN:
1-933801-36-0
© 2008
Pub Code: BP4P2-ENLAD

 
*PDF Version
After you submit your order, a link will appear directing you to download the PDF file of the book. This link will be accessible only for 24 hours, so be sure to save the file to your computer. Shipping will NOT be charged for this item.

In the years since the first insurers implemented pay-for-performance (P4P) programs to improve the quality and efficiency of care provided to patients, the field had evolved rapidly. Health Plan Pay-for-Performance Programs: The Next Generation explores the dramatic change in the scope and depth of these programs during the past several years.

Through a summary of trends in P4P programs, as well as concise case studies from three well-respected health insurers — Blue Cross Blue Shield of Michigan, HealthPartners, Inc. and Independent Health — this book contains valuable insights you'll need to establish, or modify, your own P4P program. In chapters authored by the plans themselves, Health Plan Pay-for-Performance Programs: The Next Generation looks at such trends as P4P programs with specialist physicians and PPOs, P4P programs with hospitals and programs geared toward specific diseases.

The book also includes an extensive table prepared by MedVantage, Inc., based on its exclusive survey, on who has what kinds of P4P programs — with details on the programs’ enrollment and the types of providers targeted.

Order Health Plan Pay-for-Performance Programs: The Next Generation today, and profit from the lessons learned by many of the leaders in the field!

 

Table of Contents

Six Trends in Health Insurers’ Adoption of Pay-for-Performance Programs

2006 National Pay-for-Performance (P4P) Study Results With 2007 Projections
Prepared by MedVantage, Inc.

Using Quality and Cost Measures to Drive Performance: HealthPartners’ Model
By Babette Apland, M.S., M.B.A., Senior Vice President, Health and Care Management, HealthPartners, Inc.

  • Introduction
  • Comprehensive Measurement
  • Awards and Recognition
  • Provider Engagement
  • Consumer Engagement
  • Evaluation and Results

Second-Generation Pay-for-Performance: Comprehensive Chronic-Disease Profiling
By Thomas Foels, M.D., M.M.M., Medical Director, Independent Health

  • Summary
  • Introduction
  • Methodology
  • Results
  • Discussion

Evolution of the Blue Cross Blue Shield of Michigan Hospital Pay-for-Performance Program
By Ellen Ward, Project Manager, Provider Contracting and Policy, Blue Cross Blue Shield of Michigan

  • Introduction
  • Background
  • New BCBSM Hospital Pay-for-Performance Program
  • Effectiveness of the Program
  • Future Enhancements
  • Pay-for-Performance Challenges
  • Conclusion

Written By

See Table of Contents for authors.

 

Written For

  • Health plan CEOs, network and provider relations executives, strategic planners, medical directors, financial managers and product development and marketing executives
  • Medical group executives and directors of managed care contracting
  • Hospital administrators and financial managers
  • Self-insured employers
  • Attorneys, actuaries, and consultants

 

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Related Publications

Health Plan Week
The AIS Report on Blue Cross and Blue Shield Plans
Health Plan Facts, Trends and Data

 

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Related Publications

Health Plan Week

The AIS Report on Blue Cross and Blue Shield Plans

Health Plan Facts, Trends and Data

 


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