AHIP Hi-Wire writes health insurer Medica issued more than $3 million in pay for performance (P4P) incentives in 2007 to Minnesota health care providers for improvements in the clinical care they gave to members. Medica’s P4P program focused in 2007 on asthma, chlamydia screening, diabetes, generic drug prescribing, well-child examinations, childhood immunizations, mammography, Pap tests, and high-tech imaging. Measurements assess how well chronic conditions like asthma and diabetes are managed, and the rate at which routine preventive services and exams are performed by providers participating in the program. Additional incentives reward providers driving care improvements and achieving evidence-based outcomes.
Quality measures, developed for each condition, are key. Medica reviews medical records, claims data, and now publicly available data from Minnesota Community Measurement, an effort among Medica and health plans to measure providers consistently. Measurement data are collated by the state and then reported out. Minnesota Community Measurement is one of six communities working as pilot sites with the Delmarva Foundation for Medical Care on the Better Quality Information to Improve Care for Medicare Beneficiaries (BQI) project, which is funded by the Centers for Medicare & Medicaid Services (CMS).