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June 29, 2005 Health Plans Pursue Provider P4P Programs Case Studies Of Leading Plans' Quality Incentive Efforts by Katy Henrickson with Bradford J. Holmes, Sara E. McAulay, Will McEnroe

This is an excerpt

Executive Summary

Health plans tell Forrester that they will be developing pay-for-performance (P4P) programs for their providers over the next couple of years as they respond to federal and employer initiatives to monitor — and boost — quality of care. Quality programs, such as P4P, bolster plans' consumerism offerings by giving members the information they need to become better healthcare shoppers and doctors the feedback they need to sharpen their practices. To avoid excessive costs and to minimize complexity, these programs require careful planning and execution. This report identifies key decisions that plans need to make when developing their programs, recounts three plans' early P4P experiences and lessons, and lays out the dependencies that plans and vendors must prepare for to evolve P4P over the next three to five years.

TABLE OF CONTENTS

• Pay-For-Performance Programs Move Into The Mainstream
• Plans Must Pick A Path Through Four Key Design Points
• Clinical Information Sharing Will Drive Changes To P4P Programs In The Future

RECOMMENDATIONS

• Design Efficiency Into P4P Programs While Biding Time For Clinical Data

WHAT IT MEANS

• Vendors: There's Opportunity To Help Plans Automate P4P
• Supplemental Material
• Related Research Documents

This is an excerpt