HMOs To Reward Physicians for Performance, Quality of Care

Beginning in 2004, six of the state's largest HMOs will award up to $150 million per year in bonuses to "top-performing" doctors groups under the Pay for Performance initiative, the Contra Costa Times reports (Silber, Contra Costa Times, 10/30). Participating insurers include Aetna, Blue Cross of California, Blue Shield of California, CIGNA Healthcare of California, Health Net of California and PacifiCare (Integrated Healthcare Association release, 10/29). Health plans can choose how much they will award physicians and the criteria for bonus eligibility. Hundreds of physician groups will be eligible and may receive bonuses beginning in 2004 based on performance reviews from 2003, the Times reports. Physicians will be evaluated on their scores from a patient-satisfaction survey, childhood immunization rates, cancer-screening rates, treatment of chronic conditions and the inclusion of information technology in their practices. The Integrated Healthcare Association, which launched the program in January, will make performance evaluation scores public to assist consumers in choosing doctors. IHA Executive Director Beau Carter said that "performance-based pay" systems will be standard within a few years as premiums increase and consumers continue to pay more for services. Dr. Lance Lang, senior medical director for Health Net, which has a bonus program, said, "We're already seeing benefit," adding, "We're seeing groups taking notice of the change in expectations" (Contra Costa Times, 10/30).