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Blue Shield of California Awards $29.6 Million in Pay-for-Performance Programs in 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 their diabetic patients.

Since the launch of its pay-for-performance program in 2003, Blue Shield has awarded over $78 million to providers. The pay-for-performance program has improved the health of Blue Shield members by improving multiple clinical metrics, such as increasing chlamydia screenings by 49.8 percent, HbA1c control for diabetic patients by 64.4 percent, and colorectal cancer screenings by 53 percent.

About Blue Shield of California

Blue Shield of California, an independent member of the Blue Shield Association, is a not-for-profit health plan dedicated to providing Californians with access to high quality care at a reasonable price. Founded in 1939, it now has 3.4 million members, 4,800 employees, one of the largest provider networks and more than 20 office locations, providing a wide range of commercial and government products throughout the state. The company has contributed $100 million over the past three years to the Blue Shield of California Foundation to fund nonprofit organizations that improve access to quality health care in California. Contact your local agent or broker for more information about Blue Shield products and services, or visit the Blue Shield web site at

     CONTACT: Erica Perng
              Corporate Communications Manager
              (415) 229-6171

SOURCE Blue Shield of California

SOURCE Blue Shield of California
Copyright©2009 PR Newswire.
All rights reserved

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