The Integrated Healthcare Association, the nation’s largest pay-for-performance program, will take a big step forward in the burgeoning pay-for performance movement when it adds efficiency measures to its formula for providing incentives to more than 40,000 California physicians.
“We’re beginning to see the next phase of pay-for-performance,” said Tom Williams, the IHA’s executive director. “We’ll go beyond clinical measures. As measurement science improves, we’ll get to something much more dramatic—and that is payment reform.”
The IHA said it will add information on cost and resource use to the three criteria it has used for nearly six years—clinical care, patient satisfaction and the use of information technology.
Some doctors’ organizations have harshly criticized efficiency measures as little more than efforts to control costs. But the Oakland-based IHA called the decision a “first step to realizing the Institute of Medicine’s seminar recommendations to include efficiency measures at every level of provider aggregation, and to prioritize efficiency measurements in P4P,” said Arnold Milstein, an IHA board member; national thought leader at Mercer Health and Benefits; and medical director of the Pacific Business Group on Health.
Despite concerns from the medical community, physicians in the Golden State apparently have welcomed the new measures. “By doing the clinically right thing the first time and reducing waste, we can systematically improve the quality of patient care while at the same time reduce the cost to purchasers of health insurance,” said Wells Shoemaker, medical director of the California Association of Physician Groups.
