Quest for a quality bonus: How best to position yourself for a benefit

These programs are here. Preparing to encounter them will take some effort, but it also could lead to rewards.

By Mike Norbut, AMNews staff. June 7, 2004.

The catchphrases are popping up like weeds these days. Pay for performance, quality bonus initiative and incentive pay plan are the most common terms being used to refer to what many consider to be the latest trend in medicine.

The words have different meanings to different doctors, of course. For some, the terms have little value because programs aren't offered in their area, or the work required to qualify for a bonus is too cumbersome. Others believe in the ideas and are working to capitalize on the money being floated by health plans and employers alike.

Whether you're skeptical or optimistic, however, consultants and other experts suggest you start preparing for the arrival of these programs, which are growing in popularity. Not only can you stand to gain financially by having proof of your performance when health plans come looking for information, but you also might be able to improve the efficiency of your practice in the process.

"Physicians need to get ahead of the curve. They've been reactive for too long," said Joe Mack, vice president for Aon Healthcare Alliance in its Irvine, Calif., office. "The reality is, physicians need to be proactive, so they don't get bogged down in one plan or initiative."

Last year, 40 entities, including health plans, employer coalitions, and the Centers for Medicare & Medicaid Services, had fledgling pay-for-performance programs, and that number is expected to grow to 80 in 2006, according to research by Med-Vantage Inc., a San Francisco-based consulting and market research firm that focuses on quality bonus initiatives.