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P4P Pilot demonstrated improved pediatric care

Healthcare IT News reports on the results of a quality pilot involving a collaborative of 44 pediatric practices. The quality initiative demonstrated improved care for nearly 14,000 children with asthma.

The practices comprising Ohio Valley Primary Care Associates, an IPA affiliated with the physician-hospital organization at Cincinnati Children’s Hospital Medical Center, also benefited from the pay-for-performance program linked to the initiative.

A percentage of the network’s asthma population had its severity classified, a self-management plan put into place and preventive medication prescribed, if appropriate. From October 2003 through August 2007, a composite measure of that percentage of the population increased from 4 percent to 90 percent.

In addition, the percentage of the asthma population receiving the influenza vaccine increased from 22 percent at baseline to 54 percent for the 2006-2007 flu season.

The results of the quality initiative were published in the July 2007 issue of Archives of Pediatrics and Adolescent Medicine, which concluded that linking design characteristics of a pay-for-performance program to a collaborative focused on improving care for a defined population, building improvement capability, and driving system changes at the provider level resulted in substantive and sustainable improvement.

The PHO developed the P4P component into three tiers – pay for participation, pay for network performance and pay for practice performance – with 11 of the 44 practices earning the maximum 7 percent fee schedule increase.

The pilot was a success not only in improving patient care but in rewarding participating physicians, said Barry Malinowski, MD, medical director for Anthem Blue Cross and Blue Shield of Ohio, which sponsored the P4P.

Anthem has since included asthma measures in its communitywide pediatric P4P program. At the end of 2006, 28 percent of the 3,000 participating physicians in Southern Ohio and Northern Kentucky received the full 12 percent increase, Malinowski said.

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