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The United States invests more per capita than any other nation for the delivery of health care, yet it falls short of consistently providing quality care. There are wide variations in the type of care delivered, and studies have shown that many patients do not receive recommended care. This unfortunate condition is true across medical conditions and irrespective of whether the care is preventive, acute, or chronic.

The Institute of Medicine issued a stern warning in 2001 in its ground-breaking publication, Crossing the Quality Chasm. The report urged change at all levels of the health delivery system, with particular emphasis on redesigning the system to improve quality. In particular, the publication recommended creating and aligning incentives for quality and making quality information available to enhance quality improvement, accountability, and consumer choice.

In response to this call to action, the Robert Wood Johnson Foundation and the California HealthCare Foundation funded seven demonstration projects under the Rewarding Results program to implement and evaluate financial and non-financial incentives for quality. Among the seven projects, the Integrated Healthcare Association's (IHA) Pay for Performance (PFP) program is the largest in the country to provide medical groups with incentive payments based upon performance against quality benchmarks. Seven large California health plans participate: Aetna, Blue Cross, Blue Shield, CIGNA, Health Net, PacifiCare, and Western Health Advantage. The program uses evidence-based measures to assess the performance of over 35,000 physicians in 225 medical groups caring for more than 6.2 million commercial HMO enrollees. The program's data is collected and analyzed by the National Committee for Quality Assurance (NCQA), a Washington non-profit dedicated to improving health care quality.

In addition to IHA's Pay for Performance program, similar programs are seeking to incentivize quality improvement in many US states and in other countries including the United Kingdom and Germany. The Leapfrog Hospital Rewards Program has developed a program for hospitals and health systems, and Bridges to Excellence has developed a program for physician organizations, payers, and payer coalitions operating in several locations. The Centers for Medicare and Medicaid Services has launched several demonstration projects and recently announced that it intends to incorporate Pay for Performance in its Medicare program. Proposals to include Pay for Performance in Medicare are currently being considered in U.S. congressional and senate hearings.

The overriding goal of the Pay for Performance Summit is to provide a forum to engage leading experts and policy makers in the ongoing national policy debate about the appropriate role and structure of pay for performance. An important secondary goal is to present the state of the art in Pay for Performance. This will occur in keynote presentations, panel debates and a number of specific and substantive concurrent sessions highlighting distinct issues in implementing pay for performance arrangements. The Summit will provide the most up-to-date information on what is and isn't working in Pay for Performance programs, and will offer advice from experts operating at the front lines and making it happen.

The Summit's plenary sessions and tracks, led by nationally recognized experts in their fields, will cover topics relevant to Pay for Performance programs including quality, health information technology, issues in measurement and data collection, financial incentives and legal issues, physician participation and engagement, Medicare's involvement, a national debate including contrasting views from the hospital, physician, health plan, and consumer perspectives, the international perspective, the business perspective, and reports from regional pay for performance projects across the country. Additionally, the Summit will include two Pre-conference "Boot Camps" on PFP for Hospitals and Health Systems, and PFP for Physician Organizations, Payers, and Payer Coalitions.

Who Should Attend:
  • Executives and Board Members of Health Plans, Health Systems, Hospitals and Physician Organizations
  • Medical Directors
  • Nurses, Nurse Practitioners and Other Allied Health Professionals
  • Pharmacists and Pharmacy Benefit Managers
  • Physicians
  • Purchasers, including Private Employers and Public Purchasers
  • Government Officials
  • Consumer Organization Representatives
  • Health Care Regulators and Policy Makers
  • Health Benefits Consultants
  • Health Services Researchers and Academics
  • Health Care Attorneys and In-house Counsel
  • Directors of Quality Management and Improvement
  • Directors of Government Programs
  • Directors of Medicare Programs
  • Directors of Medicaid Programs
  • Directors of Network Contracting
  • Directors of Provider Relations
  • Directors of Finance and Reimbursement
  • Pharmaceutical Executives
  • Pharmaceutical Consultants
Goals and Objectives:
  • To present a national debate of key policy issues related to Pay for Performance
  • To describe in detail the fundamentals of developing a Pay for Performance program
  • To set forth best practices in key aspects of Pay for Performance design
  • To share case studies of alternative approaches to Pay for Performance implementation
  • To question and assess the perspectives of leading experts and key policy makers on the future of Pay for Performance
  • To outline the different perspectives of key stakeholders in Pay for Performance

The National Pay for Performance Summit is sponsored by the Integrated Healthcare Association, www.iha.org, a not-for-profit, statewide collaborative leadership group of California health plans, physician groups, and healthcare systems, plus academic, consumer, purchaser, pharmaceutical, and technology representatives that promotes quality improvement, accountability, and affordability for the benefit of all California consumers through special projects, policy innovation and education.

IHA's Pay for Performance program is the largest in the country to provide medical groups with incentive payments based upon performance against quality benchmarks. Seven California health plans participate: Aetna, Blue Cross, Blue Shield, CIGNA, Health Net, PacifiCare and Western Health Advantage. IHA's mission is to create breakthrough improvements in health care services for Californians through collaboration among key stakeholders.

IHA's Roles:
  • Accountability
    IHA promotes accountability and transparency by promoting health care standards, measurements, rewards and public reporting.
  • Breakthrough Collaboration
    IHA leverages its distinctive strength, the ability to bring together leaders from key sectors of health care in California, to promote innovation through both individual and collaborative efforts.
  • Education and Information
    IHA supports a visible, ongoing effort to promote health care improvement by educating and informing the general public, policymakers, other associations and organizations through the media and other methods.
  • Policy Innovation
    IHA seeks to influence policy issues that support its mission through information exchange, public positions and innovative collaboration by key stakeholders.
  • Project Development
    IHA serves as a catalyst by initiating and coordinating projects that advance solutions for delivery system challenges.

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