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The response of physician groups to P4P incentives.
Am J Manag Care. 2007 May; 13(5):249-55.AJ

Abstract

OBJECTIVES

Despite substantial enthusiasm among insurers and federal policy makers for pay-for-performance incentives, little is known about the current scope of these incentives or their influence on the delivery of care. To assess the scope and magnitude of pay-for-performance (P4P) incentives among physician groups and to examine whether such incentives are associated with quality improvement initiatives.

STUDY DESIGN

Structured telephone survey of leaders of physician groups delivering primary care in Massachusetts. ASSESSED METHODS: Prevalence of P4P incentives among physician groups tied to specific measures of quality or utilization and prevalence of physician group quality improvement initiatives.

RESULTS

Most group leaders (89%) reported P4P incentives in at least 1 commercial health plan contract. Incentives were tied to performance on Health Employer Data and Information Set (HEDIS) quality measures (89% of all groups), utilization measures (66%), use of information technology (52%), and patient satisfaction (37%). Among the groups with P4P and knowledge of all revenue streams, the incentives accounted for 2.2% (range, 0.3%-8.8%) of revenue. P4P incentives tied to HEDIS quality measures were positively associated with groups' quality improvement initiatives (odds ratio, 1.6; P = .02). Thirty-six percent of group leaders with P4P incentives reported that they were very important or moderately important to the group's financial success.

CONCLUSIONS

P4P incentives are now common among physician groups in Massachusetts, and these incentives most commonly reward higher clinical quality or lower utilization of care. Although the scope and magnitude of incentives are still modest for many groups, we found an association between P4P incentives and the use of quality improvement initiatives.

Authors+Show Affiliations

RAND Health, Santa Monica, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

17488190

Citation

Mehrotra, Ateev, et al. "The Response of Physician Groups to P4P Incentives." The American Journal of Managed Care, vol. 13, no. 5, 2007, pp. 249-55.
Mehrotra A, Pearson SD, Coltin KL, et al. The response of physician groups to P4P incentives. Am J Manag Care. 2007;13(5):249-55.
Mehrotra, A., Pearson, S. D., Coltin, K. L., Kleinman, K. P., Singer, J. A., Rabson, B., & Schneider, E. C. (2007). The response of physician groups to P4P incentives. The American Journal of Managed Care, 13(5), 249-55.
Mehrotra A, et al. The Response of Physician Groups to P4P Incentives. Am J Manag Care. 2007;13(5):249-55. PubMed PMID: 17488190.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The response of physician groups to P4P incentives. AU - Mehrotra,Ateev, AU - Pearson,Steven D, AU - Coltin,Kathryn L, AU - Kleinman,Ken P, AU - Singer,Janice A, AU - Rabson,Barbra, AU - Schneider,Eric C, PY - 2007/5/10/pubmed PY - 2007/6/6/medline PY - 2007/5/10/entrez SP - 249 EP - 55 JF - The American journal of managed care JO - Am J Manag Care VL - 13 IS - 5 N2 - OBJECTIVES: Despite substantial enthusiasm among insurers and federal policy makers for pay-for-performance incentives, little is known about the current scope of these incentives or their influence on the delivery of care. To assess the scope and magnitude of pay-for-performance (P4P) incentives among physician groups and to examine whether such incentives are associated with quality improvement initiatives. STUDY DESIGN: Structured telephone survey of leaders of physician groups delivering primary care in Massachusetts. ASSESSED METHODS: Prevalence of P4P incentives among physician groups tied to specific measures of quality or utilization and prevalence of physician group quality improvement initiatives. RESULTS: Most group leaders (89%) reported P4P incentives in at least 1 commercial health plan contract. Incentives were tied to performance on Health Employer Data and Information Set (HEDIS) quality measures (89% of all groups), utilization measures (66%), use of information technology (52%), and patient satisfaction (37%). Among the groups with P4P and knowledge of all revenue streams, the incentives accounted for 2.2% (range, 0.3%-8.8%) of revenue. P4P incentives tied to HEDIS quality measures were positively associated with groups' quality improvement initiatives (odds ratio, 1.6; P = .02). Thirty-six percent of group leaders with P4P incentives reported that they were very important or moderately important to the group's financial success. CONCLUSIONS: P4P incentives are now common among physician groups in Massachusetts, and these incentives most commonly reward higher clinical quality or lower utilization of care. Although the scope and magnitude of incentives are still modest for many groups, we found an association between P4P incentives and the use of quality improvement initiatives. SN - 1936-2692 UR - https://www.unboundmedicine.com/medline/citation/17488190/The_response_of_physician_groups_to_P4P_incentives_ DB - PRIME DP - Unbound Medicine ER -