Pay for Performance (P4P)

                                List of Contents                                  

• Introduction/Disease Management/Guidelines

• Pay for Performance

• Bridges to Excellence

• Commonwealth Fund Opinion Leaders Survey

• Supporting P4P - example  

• Medicaid models

• Requirements for physician ‘buy-in’  

• Questions to consider before accepting a P4P proposal 

• American Academy of Family Practice Guideline - P4P

• Massachusetts Medical Society Guidelines for Measuring, Reporting, and Rewarding Physician Performance

• BlueCross BlueShield of Minnesota P4P by condition audit form links

• Computer order entry (CPOE)

• Group visits

• Quality improvement tool box, ambulatory care

• Definitions, introduction

• CQI Obstacle Busting/Bridge Building Teams  

• Electronic Medical Records (EMR)

• Medical Group Service Evaluation – patient questionnaire form

• Brief patient satisfaction example survey question

• Quality measures

• Reminders

• 7 types of interventions

• Preventive health care interventions for high risk populations

• Improving provider compliance

• HEDIS Measures

• Clinical performance measures for CAD

• Presurgical screening tests

• Follow-up tracking

• Abnormal pap smear follow-up

• Mammogram follow-up tool

• Unplanned readmissions, data collection tool  

• Unplanned readmissions - example data

• Case or care management

• Controlling Costs while Improving Quality of Care for Patients with Multiple Medical Conditions

• Clinical Performance Measures for Ambulatory Care – table (ACP)

• Case Mix Adjustment/Severity of Illness Measurement

• Ohio KePro physician office quality improvement tool kit - links

• Sentinel event reports, root analysis format –  P & P

• Quality notes  

• Provider profiles – P & P

• Feedback

• Steps to improve productivity, resource management, physician/patient satisfaction

• Ambulatory visit data

Resources

• Ethics Manual - link

• Medicare pay for performance initiatives

• Provider Profiles: Example indicators for tracking/trending

• Provider Profiling or Report Cards – Medical Group Example

• Health Plan QI/UM Clinical Indicators/Performance Goals

• Hospital/SNF QA Screens  

• Surgical Quality Indicators

• Crosby Quality Quotes  

• AHRQ ‘Prevention Quality Indicators’

• Staff quality certification resource

• Survey sampling error estimates

• References

• Thoughts for the unwary

• Web sites - links

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