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Statewide Pay-For-Performance Program in Store for New York Physicians
Date:6/10/2008

Aggregate Health Plan Data Produces Meaningful Measurement of Performance,

According to a New Report from HealthLeaders-InterStudy

NASHVILLE, Tenn., June 10 /PRNewswire/ -- HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports the New York Health Plan Association, in cooperation with a physicians' alliance and other stakeholders, is developing a statewide pay-for-performance (P4P) program for primary care physicians. According to the latest TriState Health Plan Analysis, the New York Quality Alliance (NYQA) initiative is pooling data from 12 health plans with more than four million covered lives in six regions of the state as a basis for measuring performance against 10 commonly accepted quality-care benchmarks.

"A statewide P4P evaluation for primary care physicians that aggregates all health plan data is a step in the right direction because it produces a large enough pool of data to be statistically meaningful," states Chris Lewis, market analyst for HealthLeaders-InterStudy and author of the report.

This initiative comes at a time when several HMOs have been creating their own physician ranking programs that steer members to high-performing doctors. Responding to physician outcry, Attorney General Andrew Cuomo started announcing in October 2007 a series of agreements with health plans to follow a uniform set of guidelines to ensure fairness in the system.

Different from those programs, which are based only on individual health plans' claim data, the NYQA program is pooling data from 12 health plans and is being supplemented by an adjustment factor to better reflect medical chart accuracy, which will give a broader context of the treatment provided. NYQA is relying on health plans to determine their own formula for distributing bonus payments among their contracted physicians, which could total more than $10 million beginning in 2009.

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SOURCE HealthLeaders-InterStudy
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