WellPoint Linking Annual Bonus Payments to Members’ Health
WellPoint officials on Tuesday said the company will link 5% of its employees' overall annual bonuses to measures of care that health plan members receive, the Indianapolis Star reports (Rudavsky, Indianapolis Star, 4/4).
Under the program, employees will receive larger bonuses if plan members increased their use of preventive health care, such as immunizations, cancer screenings and diabetes-management tools. The bonus calculations will be based on a "member health index," a formula that measures patients' overall health levels, including how often they visited the emergency department, how often they received preventive care and whether they were taking prescribed medications. The bonus also is based on measures such as company profitability and membership growth (Yi, Los Angeles Times, 4/4).
The index will track 20 different clinical areas to measure improvements in patient care (Murphy, AP/Houston Chronicle, 4/3). For the program, WellPoint plans to dispatch its nearly 2,000 nurse consultants to track claims and talk to patients about available care.
For example, WellPoint hopes by the end of the year to boost from 15% to 20% the percentage of its 700,000 diabetic members who receive preventive care and exams (Los Angeles Times, 4/4).
According to the Star, "no other insurer to date has tied its own employees' compensation to such measures" (Indianapolis Star, 4/4).
Sam Nussbaum, WellPoint's chief medical officer, said the program "will give us a new set of knowledge in the management of diseases."
Critics of the program say that the index "could be used to identify the sickest patients so that their premiums could be raised or their coverage canceled," the Los Angeles Times reports.
James Rohack, a cardiologist and member of the American Medical Association board of trustees, said, "If a small employer who has sicker-than-average workers were to drop out because WellPoint premiums are too high, guess what? Your index just got better." Rohack added, "And for uninsured people who need health care, with this index, WellPoint would have no incentive to sign them up" if they will bring down the index.
Arthur Levin, director of the nonprofit Center for Medical Consumers, said, "It makes you wonder. Why are (WellPoint) employees being rewarded for doing the right thing in the first place? Shouldn't prevention be the standard of care, not something you reward?" (Los Angeles Times, 4/4).