IHA names top P4P physician organizations

By Molly Merrill
04:43 PM

The Integrated Healthcare Association (IHA) named California's top performing physician organizations on Thursday, based on its statewide pay for performance program measures.

Out of more than 200 physician organizations, the 44 top performers achieved the highest overall quality in 2010 based on the IHA’s P4P program measures. In addition to celebrating the top performers, IHA presented awards to the physician organizations that demonstrated the most quality improvement from 2009 to 2010. The awards were presented at the IHA Pay for Performance Stakeholders Meeting in Los Angeles.

Both top performer and most improved awards are based on performance in four P4P quality measurement domains: Clinical Quality, Patient Experience, Information Technology-Enabled Systemness, and Coordinated Diabetes Care. As the IHA program transitions to Value Based P4P, future awards may be based on both quality of care and cost.

The three physician organizations that achieved both top performing and most improved recognition for 2010 are:

  • Palo Alto Medical Foundation – Mills-Peninsula Division/Mills-Peninsula Medical Group
  • Solano Regional Medical Group
  • Southern California Permanente Medical Group – Kern County

Sharon Katz, RN, vice president management and quality, Palo Alto Medical Foundation, Mills-Peninsula Division, noted that a number of factors were responsible for their improvement during 2010.

"We achieved a successful and seamless transition among our primary care physicians to an electronic health record," she said. "We also made great progress in successfully implementing our physician communication program, focusing on the patient-physician relationship. And finally, we focused on developing annual quality improvement work plans that, among other things, helped us achieve better performance in a majority of targeted preventative and acute care measures."

Solano Regional Medical Group (now Sutter Medical Group), which is part of the Sutter Medical Network, began taking steps to deliver care that is both high-quality and affordable several years ago, including clinical and operational leader collaboration to identify and implement best practices, comprehensive education and recognition programs.

"Every employee brings a unique perspective to improving healthcare for patients and plays a vital role in creating a highly coordinated, integrated system of care," said Fred Blair, MD, division director of quality, utilization management and network management for Sutter Medical Group in Solano County. "We're a team. By supporting and motivating each other – and even sometimes making each other laugh – we continue to advance clinical quality and enhance our patients' experiences."

The third dual award winner is the Southern California Permanente Medical Group (SCPMG) – Kern County Medical Center, whose performance is attributed in part to a clinical support structure that is focused on delivering timely and proactive patient-centered "Complete Care." This team-based model to improve preventive care and chronic conditions management includes the primary care physician, an RN care coordinator, a medical assistant or licensed vocational nurse, a pharmacist and a social medicine therapist.

"Our next step is to drive out performance variability so that we get consistent high quality care and service for all of our patients, and each patient receives the right care at the right time, every time, regardless of which physician or support team the patient sees," said Julia Bae, MD, SCPMG Kern County medical director.

Click on the next page to find out this years' top performers and most improved winners.

Top Performers
Top performing physician organizations in 2010 were identified by an overall composite score, based on their P4P domain scores, and compared against a comprehensive threshold calculated from the top 25 percent scores statewide for each P4P quality measure. Forty-four organizations met the top performers' criteria:

Northern California Top Performers

  • Hill Physicians Medical Group – Bay Region
  • Palo Alto Medical Foundation
  • Palo Alto Medical Foundation, Mills-Peninsula Division/Mills-Peninsula Medical Group
  • Solano Regional Medical Group
  • Sutter Medical Group
  • Sutter West Medical Group
  • The Permanente Medical Group, Inc., service areas: Diablo Service Area Medical Center East Bay Area Medical Center; Fresno Medical Center; Greater Southern Alameda Area Medical Center; Napa/Solano Medical Center; North Valley Area Medical Center; Redwood City Medical Center; San Francisco Medical Center; San Jose Medical Center; San Mateo/South San Francisco Medical Center; San Rafael Medical Center; Santa Clara Area Medical Center; Santa Rosa Medical Center; South Sacramento Medical Center; Stockton/Modesto/Manteca/Tracy Medical Center
  • Woodland Healthcare

Southern California Top Performers

  • Arch Health Partners
  • Bristol Park Medical Group/MemorialCare Medical Group
  • Cedars-Sinai Medical Group
  • Edinger Medical Group
  • HealthCare Partners Medical Group
  • Sharp Rees-Stealy Medical Group
  • Southern California Permanente Medical Groups: Antelope Valley; Baldwin Park; Downey; Fontana; Kern County; Los Angeles; Orange County; Panorama City; Riverside; San Diego; South Bay; West Los Angeles; Woodland Hills
  • St. Joseph Heritage Medical Group
  • St. Jude Heritage Medical Group
  • UC San Diego Health System

Physician organizations whose composite scores have improved the most over the previous year are recognized in memory of Ronald P. Bangasser, MD, who was a family physician, vice-chairman of the Board of Beaver Medical Group, and significant contributor to P4P and quality improvement initiatives in California and nationally. One of the most improved award winners this year is the Family Care Specialist Medical Group, a small but focused organization which serves a medically underserved population in East Los Angeles.

"We are pleased to be recognized for our accomplishments," said Hector Flores, MD, medical director, Family Care Specialists Medical Group. "We've achieved our results by committing to improve on the triple aim goals of patient satisfaction, improving quality, and reducing costs – and fulfilling this commitment through activities such as automating our data collection processes and developing a quality improvement plan that includes health screenings and disease management milestones. In addition, we initiated our open access program, conducted customer service training for our staff, and adopted e-prescribing as a way of eliminating redundancy, improving safety, and ensuring the appropriate use of generic medications."

Most Improved Award winners:

  • Palo Alto Medical Foundation, Mills-Peninsula Division/Mills-Peninsula Medical Group (Bay Area Region)
  • Coastal Communities Physician Network (Central Coast Region)
  • Southern California Permanente Medical Group - Kern County (Central Valley Region)
  • Solano Regional Medical Group (Sacramento/North Region)
  • Riverside Medical Clinic (Inland Empire Region)
  • Family Care Specialists (Los Angeles Region)
  • St. Joseph Hospital Affiliated Physicians (Orange County Region)
  • Children's Physicians Medical Group (San Diego Region)

Pay for Performance Payouts
In addition to being used for determining awards, the 2010 measurement year P4P results are used by seven health plans – Aetna, Anthem Blue Cross, Blue Shield of California, CIGNA HealthCare of California, Health Net of California, UnitedHealthcare and Western Health Advantage – to calculate incentive payments for distribution to physician organizations in 2011.

Since 2004, health plans have paid over $360 million in incentive payments to physician organizations for outstanding quality and service. Each health plan develops its own formula to determine payments, taking into consideration recommendations from the IHA P4P Steering Committee. 2010 payouts are distributed during the fall of 2011, and are expected to bring the total to over $400 million.