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Actionable Reports Update (Winter 2008)

The Medical Group of Ohio launched its new “Pay for Quality” program in early 2008. The program is part of MGO’s overall strategy to implement a value-based contracting model that rewards physicians for the quality care they deliver. MGO’s program is unique because physicians are provided actionable information to assist them with caring for their patients, and the employer (in this case OhioHealth) is encouraging their employees to receive the services.

 

At the beginning of 2008, MGO primary care and OB/GYN physicians who care for OhioHealth employees and their families received a list of their patients who are eligible for specific evidence-based health care services. A second list identifying patients who have not yet received the services will be mailed in mid-year. At the end of 2008 MGO physicians whose percent of patients receiving these specific health care services exceeds the baseline percent of patients who received the same services in 2007, will receive a bonus payment. One patient may be attributed to two physicians (a PCP and OB/GYN) and both physicians could be rewarded for that patient since the program does not focus on who ordered the service. Instead, the program focuses on the patient receiving the service.

 

MGO is currently working with Aetna to develop a similar program. MGO physicians will receive actionable information about their patients who are insured by Aetna, and have the opportunity for financial rewards if measurable standards are met. The initial measures focus on primary care, but measures for rewarding specialists are being explored. The Aetna Pay for Quality program is still in its early stages, and more information will be provided as the program is developed.

 

These initiatives are important steps in MGO’s ongoing strategy to develop a value-based contracting model by distinguishing MGO physicians in the market place on the basis of quality.

 


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