National Insurers Bring Programs to the State, While Market Leader Remains Out of the Mix, According to a New Report from HealthLeaders-InterStudy
NASHVILLE, Tenn., Feb. 11 /PRNewswire/ -- HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that pay-for- performance programs have yet to take hold in Arizona. According to the latest Arizona Health Plan Analysis, the state's local major insurer, Blue Cross Blue Shield of Arizona, does not currently offer pay-for-performance programs, however several of the plan's major competitors have recently brought their programs to the market.
UnitedHealthcare launched its pay-for-performance program, UnitedHealth Practice Rewards, in Arizona last fall. Arizona was one of 40 markets to see this program in 2007. The physician incentive program offers an enhanced fee schedule to physicians who meet defined criteria. Having only been in place for several months, it's too soon to provide data from the program. Aetna's pay-for-performance foray will be through Bridges to Excellence, a multi- state, multi-employer coalition founded in 2002. To be eligible for the program, physicians must be in Aetna's Arizona network and have NCQA certification for the two tracks of the program, the Diabetes Care Link and the Cardiac Care Link. As part of the program, physicians must meet clinical guidelines for treating diabetes, hypertension and cholesterol.
"Without the backing of the Arizona Blue plan, such programs will continue to be a tough sell in this market," states Heather Wicks, analyst for HealthLeaders-InterStudy and author of the report. "Support from area physicians has also been minimal as some do not see how pay-for-performance improves patient care."
While pay-for-performance programs have evolved since their introduction five years ago, it's difficult to determine their overall worth. For many programs, financial incentives were offered at the same time as other changes to improve quality, making it difficult to know if the extra money made a difference.
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