Wildly varying quality metrics, lack of transparency and low physician rewards are
hampering success of pay-for-performance programs among commercial health insurers,
according to a forthcoming report by PricewaterhouseCoopers.
The report, called Keeping Score, compared pay-for-performance programs of 10 of
the nations largest commercial payers, which collectively insure about 39 million people.
Researchers interviewed top insurance executives about the programs, and data were given on the condition that the authors would not disclose the names of the plans.
Among the 10 insurers surveyed, nearly 60 indicators of physician performance were used,
and not a single one of those indicators was used by all 10 plans, according to the
report, which will be released Wednesday. Additionally, it found no two plans rewarded providers the same way.
Whats more, quality metrics are placing an undue administrative burden on providers,
outweighing any potential cost savings, the report found. Only four of the plans publicly
report quality data on physicians. The others said they felt uneasy about publishing the
names of physicians with poor performance, according to the report. -- by href="mailto:[email protected]">Rebecca Vesely
href="mailto:[email protected]">Rebecca Vesely
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