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Blue Shield of California Awards $29.6 Million in Pay-for-Performance Programs in 2009
Date:10/5/2009

SAN FRANCISCO, Oct. 5 /PRNewswire-USNewswire/ -- Blue Shield of California announced today that it will make $29.6 million in bonuses available to medical groups and IPAs in California, and will award the money based on performance. Blue Shield will pay medical groups and IPAs for high achievement and improvement in areas that its members care the most about -- key clinical and patient experience metrics.

"At Blue Shield, we are committed to providing access to high quality care to our members," said Juan Davila, senior vice president of network management at Blue Shield of California. "Participating in the pay-for-performance program allows us to encourage best practices from physicians, control the rising cost of health care, and ensure members receive access to the care they need."

The largest portion of the dollar amount -- $12.5 million -- is linked to the Integrated Healthcare Association's (IHA) pay-for-performance program. The IHA program rewards providers for the quality of their health care services, using measures such as clinical care, diabetes care, patient experience and deployment of information technology. $9.6 million is being awarded under Blue Shield's Performance Improvement Rewards Program, which recognizes and rewards medical groups and IPAs for effectively managing emergency room visits, outpatient surgeries, inpatient bed days, and generic drug utilization. The remaining $7.5 million was awarded for shared savings and other incentive programs.

In addition to the financial rewards, Blue Shield will reach out to medical groups that ranked below average in their clinical scores to help them improve their performance. These groups will be offered tips for improving clinical care, along with information about a range of available additional resources, such as patient registries. This year, there is also a new diabetes measure created to help medical groups and IPAs improve comprehensive care for t
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SOURCE Blue Shield of California
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