TABLE 2-2 IHA Pay for Performance 2006 Measurement Set

Domain

Measure

(measurement year 2006, reporting year 2007)

Weight

Clinical

  1. Childhood immunizations

  2. Childhood upper respiratory infection (appropriate treatment)

  3. Cervical cancer screening

  4. Breast cancer screening

  5. Asthma (use of appropriate medication)

  6. Diabetes: HbA1c screening

  7. Diabetes: HbA1c control

  8. Cholesterol: LDL screening

  9. Cholesterol: LDL control <130

  10. Chlamydia screening

  11. Nephropathy monitoring for diabetic patients

50%

Patient Experience

  1. Specialty care

  2. Timely access to care

  3. Doctor–patient communication

  4. Overall ratings of care

  5. Care coordination

30%

Information Technology Investment

  1. Integrate clinical electronic datasets at group level

  2. Support clinical decision making at point of care

(Each activity is worth 5%. The maximum 20% credit requires four activities, at least two of which must be from measure 2.)

20%

SOURCE: IHA, 2006a.

and investments in technology and infrastructure. Table 2-2 lists the specific measures targeted for IHA’s 2006 program (the fourth year of the program) in three domains and the weights used to determine the share of the total possible bonus that is allocated to each domain. While performance measures are common across the seven plans, the structure of the bonus varies; most plans have opted to reward only the top performers (e.g., the top deciles or quartiles) using a bonus that is proportional to the number of the plan’s patients cared for by the group. Additionally, for the 2006 measurement/2007 reporting year, IHA encourages health plans to reward year-to-year improvement (IHA, 2006b).

Some large employers, through coalitions, are also beginning to offer direct rewards for physician performance on health care quality measures. One example is Bridges to Excellence (www.bridgestoexcellence.org), which operates in four markets and involves a collaborative effort among several large employers, including General Electric and Verizon Communications. Bridges to Excellence offers physicians who become certified by



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