OAKLAND, Calif., Sept. 24, 2013 (GLOBE NEWSWIRE) -- Today at the 2013 Annual Pay for Performance Stakeholders Meeting, the Integrated Healthcare Association (IHA) announced California's top performing and most improved physician organizations. Out of nearly 200 physician organizations, the 45 top performers achieved the highest overall benchmark for quality in 2012 based on the IHA statewide Pay for Performance (P4P) program measures. In addition to celebrating the top performers, IHA honored the physician organizations that demonstrated the most quality improvement from 2011 to 2012.
Awards are based on performance in three P4P quality measurement domains: meaningful use of health information technology, patient experience, and clinical measures that include priority conditions such as cardiovascular, diabetes, musculoskeletal, respiratory, and prevention.
Top Performers – Highest Overall Quality of Health Care
Top performing physician organizations for 2012 were identified by an overall composite score, based on their P4P domain scores, and compared against a comprehensive benchmark calculated from the top 25 percent scores statewide for each P4P quality measure. Forty-five organizations met the top performers' criteria for 2012:
Northern California Top Performers
- John Muir Health
- Mercy Medical Group/Dignity Health Medical Foundation
- Meritage Medical Network
- Palo Alto Medical Foundation - Mills-Peninsula Division/Mills-Peninsula Medical Group
- Palo Alto Medical Foundation - Sutter Health
- Sutter East Bay Medical Foundation
- Sutter Gould Medical Foundation
- Sutter Medical Group
- Sutter Medical Group of the Redwoods
- The Permanente Medical Group, service areas: Diablo/Antioch Medical Centers; Fremont/Hayward Medical Centers; Fresno Medical Center; Modesto/Manteca/Stockton Medical Centers; Oakland/Richmond Medical Centers; Redwood City Medical Center; Roseville/Sacramento Medical Centers; San Francisco Medical Center; San Jose Medical Center; San Rafael Medical Center; Santa Clara Medical Center; Santa Rosa Medical Center; South Sacramento Medical Center; South San Francisco Medical Center; Vallejo/Vacaville Medical Centers
Southern California Top Performers
- Arch Health Partners
- Cedars-Sinai Medical Group
- HealthCare Partners Medical Group
- MemorialCare Medical Group
- Primary Care Associates Medical Group
- Sharp Rees-Stealy Medical Group
- Southern California Permanente Medical Group: Antelope Valley; Baldwin Park/San Gabriel Valley; Downey; Fontana/Ontario; Kern County; Los Angeles; Orange County; Panorama City; Riverside; San Diego; South Bay; West Los Angeles; Woodland Hills
- St. Joseph Heritage Medical Group
- UC San Diego Medical Group
Most Improved – "Ronald P. Bangasser, MD, Memorial Award for Quality Improvement"
Physician organizations whose composite scores have improved the most over the previous year are recognized with the Ronald P. Bangasser, MD, Memorial Award for Quality Improvement. The most improved award winners for this year are:
- AMVI Medical Group, managed by Prospect Medical Systems, Inc. (Orange County Region)
- Choice Medical Group (Inland Empire Region)
- John Muir Health (Bay Area Region)
- Mercy Medical Group/Dignity Health Medical Foundation (Sacramento/North Region)
- PIH Health Physicians – Group Division (Los Angeles Region)
- Sansum Clinic (Central Coast Region)
- Sharp Rees-Stealy Medical Group (San Diego Region)
- Sutter Gould Medical Foundation (Central Valley Region)
Four Organizations Achieve Both "Top Performing" And "Most Improved" Awards
- The four physician organizations that achieved both top performing and most improved recognition for 2012 are: John Muir Health, Sharp Rees-Stealy Medical Group, Mercy Medical Group (Dignity Health Medical Foundation), and Sutter Gould Medical Foundation. "This is a significant achievement," says Dolores Yanagihara, Vice President of Performance Measurement & Analytics at IHA, "because it is difficult to keep improving when you are already performing at a high level."
Changes Coming to Pay for Performance Design
Starting in 2013, the California P4P program is undergoing a transformation to Value Based P4P, which incorporates healthcare costs and appropriate resource use along with quality. Value Based P4P is a key step in holding physician organizations responsible for both the quality and cost of care delivered to their members, and is aligned with the national movement towards Accountable Care Organizations and other value based purchasing approaches.
Pay for Performance Payouts
In addition to being used for determining awards, the 2012 P4P results are used by seven health plans – Aetna, Anthem Blue Cross, Blue Shield of California, Cigna HealthCare of California, Health Net of California, UnitedHealthcare, and Western Health Advantage – to calculate incentive payments for distribution to physician organizations in the fall of 2013. Since the California P4P program's inception in 2003, health plans have paid over $450 million (not including 2012) in incentive payments to physician organizations for outstanding quality and service. Each health plan develops its own formula to determine payments, taking into consideration recommendations from the IHA P4P Governance Committee.
About the Integrated Healthcare Association (IHA)
IHA is a statewide leadership group that promotes quality improvement, accountability, and affordability of healthcare in California. The IHA P4P program is the largest non-governmental physician incentive program in the U.S. and includes eight health plans (including Kaiser Permanente for reporting only) and nearly 200 physician organizations representing approximately 35,000 physicians providing care for about 9 million members. Other IHA programs include: bundled episode of care payments, the measurement and reward of healthcare efficiency, healthcare affordability, administrative simplification, and accountable care organizations. For more information, please visit: www.IHA.org.