Eyes on the prize

Key Points

Family Practice Associates PA (FPA), a five-physician practice in inner-city Wilmington, Delaware, got a phone call back in 2007 that few practices expect ever expect to receive.

On the other end of the line was Delaware Physicians Care Inc., the managed care company that administers its Medicaid claims, and it was sending the practice a bonus of more than $10,000 to reward FPA for its quality of care.

FPA has earned the pay-for-performance bonus every year since then. To date, it has collected $49,590 over 4 years.

"Most [health insurance] companies just collect your data and say, 'thanks a lot,' or they say, 'you guys are doing poorly,' says Edward Sobel, DO, family physician and practice co-partner owner. "I think if most insurance companies were to share some of their savings, that would be a driving incentive."

Aside from the Medicaid plan, FPA doesn't receive financial incentives from its other payers for its quality care, even though the practice achieved recognition from the National Committee for Quality Assurance (NCQA) for its care for patients with diabetes. However, if other insurers were to offer pay-for-performance incentives similar to its Medicaid plan, FPA would be well-positioned to take advantage of them, Sobel says.

PAY-FOR-PERFORMANCE HERE TO STAY

In 2008, there were more than 91 physician and hospital pay-for-performance programs covering more than 150 million members, according to MedVantage, an industry software developer that conducts a semi-annual payer survey. More regional commercial plans across the country are starting to embrace these programs as more practices adopt electronic health records, making it easier to share data.

Here are a few recent examples:

"There's really no other way," Sobel says. "You just have to keep hammering away at it."