In the years since the first insurers implemented pay-for-performance (P4P) programs to improve the quality and efficiency of care provided to patients, the field had evolved rapidly. Health Plan Pay-for-Performance Programs: The Next Generation explores the dramatic change in the scope and depth of these programs during the past several years.

Through a summary of trends in P4P programs, as well as concise case studies from three well-respected health insurers — Blue Cross Blue Shield of Michigan, HealthPartners, Inc. and Independent Health — this book contains valuable insights you'll need to establish, or modify, your own P4P program. In chapters authored by the plans themselves, Health Plan Pay-for-Performance Programs: The Next Generation looks at such trends as P4P programs with specialist physicians and PPOs, P4P programs with hospitals and programs geared toward specific diseases.

The book also includes an extensive table prepared by MedVantage, Inc., based on its exclusive survey, on who has what kinds of P4P programs — with details on the programs’ enrollment and the types of providers targeted.

Order Health Plan Pay-for-Performance Programs: The Next Generation today, and profit from the lessons learned by many of the leaders in the field!

Table of Contents

• Six Trends in Health Insurers’ Adoption of Pay-for-Performance Programs

• 2006 National Pay-for-Performance (P4P) Study Results With 2007 Projections Prepared by MedVantage, Inc.

• Using Quality and Cost Measures to Drive Performance: HealthPartners’ Model By Babette Apland, M.S., M.B.A., Senior Vice President, Health and Care Management, HealthPartners, Inc.
  • Introduction
  • Comprehensive Measurement
  • Awards and Recognition
  • Provider Engagement
  • Consumer Engagement
  • Evaluation and Results
  
  
• Second-Generation Pay-for-Performance: Comprehensive Chronic-Disease Profiling By Thomas Foels, M.D., M.M.M., Medical Director, Independent Health
  • Summary
  • Introduction
  • Methodology
  • Results
  • Discussion
  • Evolution of the Blue Cross Blue Shield of Michigan
  
  
• Hospital Pay-for-Performance Program By Ellen Ward, Project Manager, Provider Contracting and Policy, Blue Cross Blue Shield of Michigan
  • Introduction
  • Background
  • New BCBSM Hospital Pay-for-Performance Program
  • Effectiveness of the Program
  • Future Enhancements
  • Pay-for-Performance Challenges

• Conclusion
• Written By

Written For

• Health plan CEOs, network and provider relations executives, strategic planners, medical directors, financial managers and product development and marketing executives
• Medical group executives and directors of managed care contracting
• Hospital administrators and financial managers
• Self-insured employers
• Attorneys, actuaries, and consultants

International orders will be fulfilled in PDF format via email.