California Pay for Performance Results

Several major California health plans participate in a joint pay for performance plan for physicians.  The Integrated HealthCare Association has responsibility for tracking and assessing the program’s results.  It has released 2008 performance results.  (IHA Report) The program measures a number of clinical treatments, such as immunizations, cholesterol management, diabetes and cancer screenings; as well as patient experience factors and use of health information technology.  In general, there was continued progress on the clinical measures, and use of IT, with patient experience remaining about the same as the prior year.

The report notes the geographic variation in California, with the Bay Area and Sacramento doing better than Los Angeles and the Inland Empire.  IHA also interprets the data as suggesting that being more IT-enabled is associated with higher scores.  A caveat which IHA should note is that better systems may merely mean that there is better recording and reporting of data, not necessarily that the care is actually any better.  IHA has received grants to study further the cause of regional and provider variation in performance.  The results of this research should be helpful.  At a minimum the California pay-for-performance program has succeeded in focusing physician attention on improving care delivery.