California doctors to see higher pay-for-performance pay

Efforts are now focusing on getting physicians in solo and small practices into the program.

By Tyler Chin, AMNews staff. Aug. 8, 2005.

California physicians are expected to share $70 million to $80 million in bonus payments from their participation in a private pay-for-performance plan.

Although the size of the payout hasn't been finalized, it's anticipated to top the $40 million doctors received in 2004 from the Integrated Healthcare Assn.'s pay-for-performance program, said Ronald Bangasser, MD, a family physician who is on IHA's board of directors and is a past president of the California Medical Assn.

The key reasons for the expected payment increase are that there were more clinical performance measures, and that participating physicians improved upon their first-year performance, Dr. Bangasser said.

Under the 2½-year-old program, seven of the country's largest health plans have pledged to pay tens of millions of dollars in annual bonuses to physicians who meet certain clinical, patient satisfaction and information technology criteria. IHA has forwarded the report to the insurers, who use it to determine how much they will pay some 35,000 physicians in 225 medical groups.

The flow of payments was expected to start as early as late July, said Tom Williams, executive director of IHA, Walnut Creek, Calif., which runs the pay-for-performance program.

On the clinical side, doctors performed well across all 14 clinical measures revolving around childhood immunization, cervical and breast cancer screenings, and asthma, diabetes and cholesterol management.

While the rate of improvement varied from measure to measure, some were more statistically significant than others, meaning that those results weren't likely due to chance, said Linda Shelton, an assistant vice president at the National Committee for Quality Assurance, Washington D.C., which collected and analyzed the data for the report. Those areas included cervical cancer, asthma and diabetes care, she said.