Pay-for-Performance Program

Categories: Change Incentives to Promote Better Care

Blue Shield of California participates in a statewide pay-for-performance program that offers a uniform incentive structure for California physician groups and a publicly accessible scorecard on provider performance.  The initiative promotes high-quality, affordable healthcare by focusing on clinical performance, patient experience, health IT use and other criteria developed by the Integrated Healthcare Association (IHA).

For example, Blue Shield’s program uses the IHA standards to track physician groups’ performance on factors such as adolescent immunization rates, blood sugar monitoring for diabetics and the use of effective control medications for members with asthma.  In 2007, the Plan awarded more than $31 million in bonuses to medical groups across its network for implementing best practices to improve healthcare delivery and patient outcomes.