Pay for Performance (P4P) 2013
Apollo Managed Care, Inc., January 2013, Pages: 96
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
Reminders
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
Feedback
Steps to improve productivity, resource management, physician/patient satisfaction
Ambulatory visit data
Resources
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
References
Thoughts for the unwary
Web sites – links
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