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Pay for Performance

Pay-for-Performance (P4P) initiatives are being established by employers, insurers and private payers throughout Minnesota and nationally. Most programs include quality indicators for common chronic diseases, use of electronic health records, and patient satisfaction.

The Centers for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ) are supporting demonstration projects that provide data regarding the efficacy and usability of P4P programs.

The Minnesota Medical Association (MMA) supports transparent valid, and useful measurement and public reporting and performance measurement at the medical group and hospital/facility level. Given the need for statistical validity and the limitations of current measurement techniques, the MMA does not support clinical performance measurement at the individual physician level.

There are two primary types of measures to evaluate the clinical quality of the care delivered – process and outcome. While the MMA acknowledges that outcomes are the ideal measurement of quality health care, given the methodological limitations, the MMA believes that in most circumstances process measures linked with meaningful differences in outcomes are the most viable metrics for evaluating quality of clinical care.

Learn More

Pay for Performance Measures Used Across Minnesota (February 2009)
MMA Pay for Performance principles
MMA Tiering Report
Agency for Health Care Policy and Research
American Medical Association (AMA) Pay for Performance page
Centers for Medicare and Medicaid Services' Physician Quality Reporting Initiative (PQRI)
Institute for Healthcare Improvement (IHI

 

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