Second National Pay-for-Performance Summit
Venue: Beverly Hilton
Location: Los Angeles, California, United States
Event Date/Time: Feb 14, 2007 | End Date/Time: Feb 16, 2007 |
Description
On the state level, IHA recently announced continued across-the-board quality improvements in clinical care and increased adoption of health information technology in physician groups participating in the third year of its California PFP program. Other influential organizations continue to promote PFP programs with similar quality improvement goals. For example, the Leapfrog Group recognizes and rewards hospitals for their performance in both the quality and efficiency of in-patient care with their Leapfrog Hospital Rewards PFP program. Bridges to Excellence, a multi-state, multiple employer initiative, encourages advances in quality across the healthcare system through measurement, reporting, rewards, and education. In addition, the recently passed health coverage bill in Massachusetts outlines a PFP system in which health care providers must show that they are meeting certain quality standards in order to receive hundreds of millions of additional Medicaid dollars.
Nationally, the Centers for Medicare and Medicaid Services' (CMS) demonstration project evaluating PFP measures tying Medicare hospital payments to quality of care measures has shown dramatic potential reductions in the program's hospital costs for the care of certain conditions. Last year CMS also established a voluntary reporting system in which physicians report on 16 quality indicators for ambulatory care. Internationally, the PFP program introduced by the National Health Service of the United Kingdom, basing individual primary care physicians' salary increases on their success in meeting 146 criteria for high-quality performance, paid out on average an additional $40,000 per physician in the program's initial year.
As PFP programs develop and mature, several key features emerge as focal points. First, collaboration among all the stakeholders is essential. IHA's report on the first five years of its PFP program, "Advancing Quality through Collaboration," emphasizes the critical cooperation among health plans and physician groups that led to the program's success. Second, transparency through wide-scale public reporting on the quality of performance is important to motivate a higher quality of care. Third, government programs such as Medicare and Medicaid will likely adopt and influence the development of PFP programs. Fourth, measurement in PFP is likely to extend beyond quality indicators and measures of patient satisfaction and adoption of information technology to include efficiency measurement. The wide variations in the cost of care with no apparent relation to the quality of care have driven purchasers, health plans, and policy-makers to look for ways to get more value from the health care dollar, and to consider how well physicians are controlling costs while still maintaining quality. Finally, we can expect PFP in this country eventually to extend beyond the ambulatory care setting to include the participation of hospitals, specialists, and surgeons, as well as primary care doctors.
Who Should Attend:
Executives and Board Members of Health Plans, Health Systems, Hospitals and Physician Organizations
Medical Directors
Nurses, Nurse Practitioners and Other Allied Health Professionals
Pharmacists and Pharmacy Benefit Managers
Physicians
Purchasers, including Private Employers and Public Purchasers
Government Officials
Consumer Organization Representatives
Health Care Regulators and Policy Makers
Health Benefits Consultants
Health Services Researchers and Academics
Health Care Attorneys and In-house Counsel
Directors of Quality Management and Improvement
Directors of Government Programs
Directors of Medicare Programs
Directors of Medicaid Programs
Directors of Network Contracting
Directors of Provider Relations
Directors of Finance and Reimbursement
Pharmaceutical Executives
Pharmaceutical Consultants
Learning Objectives:
After attending the National Pay for Performance Summit, participants will be able to:
Understand the strategies necessary to create a community collaboration that supports data collection and performance measurement.
Explain new models for rewarding performance and new tools that can be used to align incentives to achieve performance excellence, including efficiency measurement in P4P, Prometheus, and gainsharing.
Recognize the role that P4P plays in government programs, including Medicare.
Discuss the roles that hospitals, health systems, purchasers, and physicians play in P4P.
Understand the findings and evidence on the efficacy of P4P programs.
Discuss the relationship of electronic data collection, IT, and performance measurement.
Explain the best ways to achieve physician and nurse engagement in P4P.
Understand the important role nurses play in the P4P movement.
Identify several successful P4P programs across the nation and in England.
Understand Leapfrog's Hospital Rewards Program and how to implement it.
Describe the Bridges to Excellence and Prometheus programs.
Identify how P4P programs deal with racial disparities.
Explain how to achieve better outcomes with P4P programs.
Distinguish the perspectives of primary care physicians and various medical specialists on performance measurement.
Identify legal considerations concerning P4P.
Understand the overall role of P4P in the future of American healthcare.
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