Medicare involvement would bring “a huge amount of energy and focus to performance measurement,” Tom Williams, executive director of the Integrated Health Association, the largest pay-for-performance program in the U.S., said in an interview for a California Healthline special audio report (Rebillot, California Healthline, 8/23).
Under the budget savings bill signed by President Bush in February, CMS must develop a plan to connect hospital performance to payments by 2009 (California Healthline, 6/22).
Health information technology is “hugely essential” to the growth of pay-for-performance programs, some of which use manual chart review and tracking, according to Williams. “If you’re going to do a significant program … in terms of size and scope … you really need to focus on electronic means,” especially data exchange between organizations and data collection by physician groups at the office level, Williams said. IHA, which only collects data electronically, has set a priority for the next three years of measuring more data in clinical settings, an objective Williams said poses a challenge as a “limited set of well-vetted measures” exists that can be collected electronically.
In addition, Williams said that risk-adjustment methodologies for measurement systems should “take a higher profile” as pay-for-performance programs “become more substantial and serious” so that providers are not penalized for providing care to patients who are sicker or who do not respond to treatments recommended in practice guidelines used in the programs.
California-based IHA includes eight health plans, 35,000 physicians and 12 million consumers receiving information on care elements. IHA will hold its second pay-for-performance summit in Los Angeles in February (California Healthline, 8/23).
The complete audio of the interview is available online for download in mp3 format
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