Physicians will earn cold, hard cash for measurable patient improvement under a new initiative unveiled today by an alliance of doctors, employers and health plans. And founders hope doctors will reinvest the rewards to better their office systems and provide higher-quality care to patients.
Employers participating in the Bridges for Excellence program will pay doctors up to 10% in bonuses for measurable improvement in diabetes care, cardiovascular care and patient care management systems.
One of the enterprise's most important aspects is the focus on office systems, according to Thomas Lee, M.D., CMO of Partners Community HealthCare in Boston.
"A lot of physicians would like to invest in information systems to help deliver better care, but insurance payments haven't covered these costs," Lee says. "Bridges to Excellence changes the financial picture--it makes investing in systems to improve care easier."
Partners, the Lahey Clinic in Burlington, Mass., and Cincinnati Children's Hospital are the providers who helped create Bridges. CMS also participated in the pay-for-quality program. General Electric Co., Ford Motor Co., Proctor & Gamble Co., UPS and Verizon are among the companies investing in the rewards.
The initiative is being launched in markets where participating employers have a critical presence. When physicians have an opportunity to treat more patients with chronic disease who work for these companies, it better ensures the adequacy of the physician reward, according to Jon Conklin, vice president of Medstat, which will manage the program.
Several physicians in Cincinnati who already meet some of the clinical criteria will see their first checks in June. As the program unfolds, additional payments will be made quarterly.
With a graduated, progressive reward system for the office-management component, even small physician organizations will be able to earn bonuses for participation, says Francois de Brantes, healthcare program leader for G.E. Those who have been reluctant to pay for information systems up front "will know with a degree of certainty what the return on investment will be," he says.
"If all you have is a registry, you will get a reward for having one of these basic tools," he says. "It gives you money to reinvest in a better system. You can move to the next stage and get another reward the next time."
Lee says the role of delivery systems like Partners and Lahey is to help doctors meet the criteria so they can move to the next level.
Employers plan to recruit physicians to help grow the voluntary incentive program, Conklin says.
"It will be different for physicians who are used to getting calls from health plans to be getting calls from employers," he says. "It will weigh even more heavily on their eagerness to participate."
The initiative will begin with three programs in select cities. Diabetes Care Link will be launched in Cincinnati, Louisville, Ky., and Boston. It is based on an existing physician recognition program designed by the National Committee on Quality Assurance and the American Diabetes Association. Bonuses will be provided to physicians who demonstrate good control of their patients with diabetes.
Physician Office Link will be piloted in Boston. Cardiac Care Link, to be introduced later in 2003, will reward good management of patients with ischemic vascular disease.