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Pay for Performance (P4P) 2013 Product Image

Pay for Performance (P4P) 2013

  • Published: January 2013
  • Region: Global
  • 96 Pages
  • Apollo Managed Care, Inc.

Evolution of P4P from physician profiles and report cards to current concepts; pros, cons, quality issues, and model programs that are now functioning successfully, Medicare plans for P4P compensation program, extensive references, resources, web links, benchmarks.

Introduction/Disease Management/Guidelines

Pay for Performance

Bridges to Excellence

Commonwealth Fund Opinion Leaders Survey

Supporting P4P – example

Medicaid models

Requirements for physician ‘buy-in'

Questions to consider before accepting a P4P proposal

American Academy of Family Practice Guideline – P4P

Massachusetts Medical Society Guidelines for Measuring, Reporting, and Rewarding Physician Performance

BlueCross BlueShield of Minnesota P4P by condition audit form links

Computer order entry (CPOE)

Group visits

Quality improvement tool box, ambulatory care

Definitions, introduction

CQI Obstacle Busting/Bridge Building Teams

Electronic Medical Records (EMR)

Medical Group Service Evaluation – patient questionnaire form

Brief patient satisfaction example survey question

Quality measures


7 types of interventions

Preventive health care interventions for high risk populations

Improving provider compliance

HEDIS Measures

Clinical performance measures for CAD

Presurgical screening tests

Follow-up tracking

Abnormal pap smear follow-up

Mammogram follow-up tool

Unplanned readmissions, data collection tool

Unplanned readmissions – example data

Case or care management

Controlling Costs while Improving Quality of Care for Patients with Multiple Medical Conditions

Clinical Performance Measures for Ambulatory Care – table (ACP)

Case Mix Adjustment/Severity of Illness Measurement

Ohio KePro physician office quality improvement tool kit – links

Sentinel event reports, root analysis format – P & P

Quality notes

Provider profiles – P & P


Steps to improve productivity, resource management, physician/patient satisfaction

Ambulatory visit data


Ethics Manual – link

Medicare pay for performance initiatives

Provider Profiles: Example indicators for tracking/trending

Provider Profiling or Report Cards – Medical Group Example

Health Plan QI/UM Clinical Indicators/Performance Goals

Hospital/SNF QA Screens

Surgical Quality Indicators

Crosby Quality Quotes

AHRQ ‘Prevention Quality Indicators'

Staff quality certification resource

Survey sampling error estimates


Thoughts for the unwary

Web sites – links

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