Federal Grant Supports Blue Cross And Blue Shield Foundation On Health Care Summit On Pay-For-Quality (6/2/2005)

AHRQ Sponsors Summit On Quality-Based Physicians Incentive Programs

CHICAGO – Evidence-based medical practices in the United States are not followed 45 percent of the time, according to a recent RAND study. This creates inconsistency in care, affects quality and patient satisfaction, and ultimately leads to higher healthcare costs according to the study. Blue Cross and Blue Shield Companies across the country have been working with physicians on how to best reward and improve quality care, through pay for quality programs.

In an effort to quantify the effectiveness of physician pay for quality programs, the Blue Cross and Blue Shield Foundation on Health Care (BCBSFHC) will lead the Quality-Based Physician Incentive Programs Summit on June 2-3 in Arlington, VA, funded in part by a grant from the Agency For Healthcare Research and Quality (AHRQ).

"We know that better knowledge leads to better, more affordable care for consumers," said Maureen Sullivan, Senior Vice President for the Blue Cross and Blue Shield Association, which is providing in-kind support to the summit. "The information disseminated from this conference is a major component in building our future healthcare system. It's important that we find ways not only to reward quality care, but also ways of improving care quality to meet widely accepted, evidence-based clinical standards for care."

Blue Cross and Blue Shield Plans have been among the leaders in designing and implementing physician reimbursement programs that are tied to quality performance indicators. For example:

• Hawaii Medical Service Association's (Blue Cross and Blue Shield of Hawaii) Physician Quality and Service Recognition program demonstrates how health insurers and physicians are working together to develop programs to improve healthcare quality while maintaining economic efficiency and the successful development of numerous evidence-based indicators.

   

• Pittsburgh-based Highmark Blue Cross Blue Shield, for example, launched its Performance Based Incentive Program (PBIP) in 2000. The PBIP program helps monitor and streamline medical guidelines so that physicians are informed of medical breakthroughs, new techniques and improved technology.

   

• Blue Cross Blue Shield of Massachusetts sought to improve the quality of preventative services when it developed a Primary Care Physician (PCP) Incentive Program in 2000. The program gives PCPs the opportunity to earn additional reimbursement above the HMO fee schedule based on their performance on specific quality measures.

The BCBSFHC Quality-Based Physician Incentive Programs Summit will be a two-day session with a primary audience of experts from throughout the Blue Cross and Blue Shield System, leading investigators and employers in areas of payment for quality, representatives from AHRQ and The Centers for Medicare & Medicaid Services (CMS). The summit will review and evaluate current experiences with quality-based incentive programs and make recommendation for ongoing review of incentive programs.