California doctors closer to reaping bonuses

Insurers participating in the performance initiative announce payouts; tougher quality standards are expected in 2004.

By Mike Norbut, AMNews staff. Oct. 6, 2003.

Physician groups involved with Integrated Healthcare Assn.'s "Pay for Performance" are getting more information about what their quality bonuses will be.

When organizers announced the initiative, which is estimated to affect some 40,000 physicians, they estimated bonus totals between the six participating health plans could reach $150 million. The most frustrating aspect of the initiative for physicians, however, has been waiting for plans to announce how much money they will contribute to the project, and how the bonus payments would be made.

Beau Carter, IHA executive director, said that last month he put together a comprehensive spreadsheet of bonus plans after the last insurer, CIGNA, made its intentions public. Because of antitrust issues, insurers were prohibited from discussing payment plans with each other.

In addition to its current "Provider Group Rewards Program," CIGNA also plans to reward the top 50% of groups in each of the IHA categories. Top performing groups would receive a minimum of $1.60 per member per month. Other plans have continued to operate their own bonus initiatives before making payments under the IHA initiative next year. Blue Cross of California, for example, recently announced $28 million in payouts to about 80 groups across the state.