The largest private pay-for-performance program in the country has had major successes, including health information technology adoption, but has overall "fallen short of expectations," according to a retrospective report.
The Integrated Healthcare Association's California Pay for Performance program, now in its seventh year, today includes eight health plans, 35,000 physicians and 11.5 million HMO members.
In a report looking at its achievements since 2006
, Oakland, Calif.-based IHA concludes that patient experience gains have been marginal and costs should have been a consideration earlier on.
Although average clinical performance has steadily improved, there are significant regional variations across the state, according to the report.
On a brighter note, IT to support better care has substantially improved. In 2007, two-thirds of physician groups participating showed some IT capability for measuring pay-for-performance, about double since 2003. And one-third have robust care-management processes, according to the report.
Electronic prescribing among participating medical groups is above the national average, with 18% doing e-prescribing, compared with 5% in 2003. The national average is about 12%. About 40% of participating groups can access laboratory results electronically, and 43% can see clinical notes electronically today, according to the report.
Compensation has been an issue. Incentive payments were less than 2% of physician group compensation, far short of a goal of 10% and lower than the national average of 5% to 6%, according to the report.
"P4P is not the answer," IHA concludes. "Rather, it is an important step to building a foundation of accountability, continuous quality improvement and effective payment reform in healthcare."
What do you think? Submit a letter to Your Views. Please include your name, title, company and hometown. Health IT Strategist reserves the right to edit all submissions.
Also, please share your thoughts by taking our latest HITS reader poll.