California Pay for Performance (P4P) is a statewide collaboration that creates the business case for physician organization (PO) quality. The Integrated Healthcare Association (IHA), a nonprofit, statewide health care leadership group composed of health plans, physician groups, hospitals, health care systems, purchasers, pharmaceutical, technologic, consumer and academic representatives, engages various sectors of health care delivery in dialogue and collective action to develop policy and special projects centered on integrated health care and managed care. IHA helps California’s Health Plans reward POs for performance in clinical care, information technology (IT) adoption and patient experience by providing a clear set of health plan expectations, using common metrics and public reporting.
NCQA, IHA’s data aggregator for the P4P Program, coordinates, collects, aggregates, analyzes and reports both health plan and PO clinical quality measures and Information Technology Development data. These data are integrated with patient experience data and reported to help health plans determine the financial reward paid to participating California POs. NCQA also is technical advisor and consultant in P4P measure development, testing and implementation.
Currently, 7 California health plans (representing more than 6.2 million enrollees) participate in P4P: Aetna, Blue Cross of California, Blue Shield of California, CIGNA HealthCare of California, Health Net, PacifiCare and Western Health Advantage. Approximately 250 California Physician Organizations are included in the reporting.
For more information, please contact NCQA Customer Support at (888) 275-7585.