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Calif. P4P program sees IT improvements: report


By Rebecca Vesely
Posted: July 17, 2009 - 11:00 am ET
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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.

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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."

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