By Donna Marshall
As of today, we have mailed checks totaling $79,240 to 201 physicians across Colorado for their care of patients in 2012.
Its our way of thanking them for delivering optimal care, and it bodes well for their patients with chronic conditions.
Traditional fee-for-service medicine rewards doctors and hospitals for providing more services. But for patients with chronic conditions, such as diabetes or cardiovascular problems, the point is to avoid costly services related to bad outcomes, such as emergency department visits or long hospital stays.
Instead, the best approach is to keep patients as healthy as possible through monitoring of key health indicators, education and coordination of services.
Thats why eight years ago, a number of Colorado health plans and employers joined together to reward physicians who effectively treat diabetic and heart disease patients.
Working through the national Bridges to Excellence program, under the leadership of the Colorado Business Group on Health, employers and health plans set up a pay-for-performance program for doctors who prove that their patients surpass national, rigorously tested benchmarks for optimal care.
Its an alternative form of payment that rewards the quality, not the quantity, of medical care delivered.
Last year, an investigator from Harvard calculated that patients of recognized doctors were less likely to need to use the emergency room, less likely to be admitted to the hospital and, if admitted, would have to stay fewer days than patients with diabetes who do not have this benefit.
The verdict is in: patients treated by physicians who embrace payment for quality, not quantity, are more likely to get the routine care they need and have fewer avoidable complications. All told, these patients enjoy better health. And better health reduces their out-of-pocket expenses and cuts costly care for the employer or health plan.
So while some may consider incentive payments to be a waste of money, its a pittance compared to the money saved and lives improved when doctors and patients achieve recommended health goals. And it sends a strong signal to the market that payment reform pays dividends.
To find out if your physician is on the list of recognized physicians, download the full report at: http://www.coloradohealthonline.org.
Donna Marshall is the executive director of the Colorado Business Group on Health, an innovative, employer-led nonprofit that focuses on what really matters in health care: value. Through education, pilot projects and practical purchasing tools, CBGH helps forward-thinking Colorado employers get more value for their health care dollars. Reach her at firstname.lastname@example.org.