PTPN`s Outcomes Program is first to measure efficiency for true P4P.
Transcription
PTPN`s Outcomes Program is first to measure efficiency for true P4P.
Measuring REAL Provider Performance PTPN’s Outcomes Program is First to Measure Efficiency for True P4P If you were the judge at a cooking competition, who would get the prize: the chef who did the best job following the recipe, or the one who made the most delicious meal? With outcomes, as with cooking, the proof is in the pudding. As a payer battling soaring medical costs, you want the providers who are the most efficient at getting patients better. Yet, surprisingly, the first pay-for-performance programs have focused on measuring how well clinicians follow the steps that are supposed to produce good outcomes. Medicare, for instance, pays healthcare providers merely for reporting measures, not for the actual achievement of quality outcomes. Other programs have found that achieving processdriven quality measures does not necessarily reduce costs. For example, seven plans in California paid physician groups a total of $65 million, according to the Integrated Healthcare Association (IHA).1 But because those P4P programs haven’t saved any money yet, the IHA is devising efficiency measures that include resource use.2 Efficiency is the key performance measure The lesson for payers is: Before you invest your scarce resources in providers, make sure you have a reliable yardstick to measure provider performance. The more effective and efficient the provider, the lower your overall costs will be. First outcomes program for rehab measures true results Rehabilitation therapists are a critical group of healthcare providers whose efficiency can significantly impact both your members’ health and your bottom line. These professionals help patients recover from the three most costly healthcare ailments – heart conditions, trauma disorders, and cancer – as well as such illnesses and injuries as osteoporosis and back problems, conditions that drive up costs and sap productivity.3 The PTPN Outcomes Program, powered by FOTO,4 now offers the first outcomes measurement system for rehabilitation that lets you measure and recognize the providers who are the most efficient in delivering superior outcomes. This program: • Predicts at initial evaluation the number of expected visits needed for a patient with a particular problem and particular medical history. • Produces a provider efficiency score based on the number of visits a patient had combined with the improvement in function over the course of treatment. • Compares providers to their peers on a national level. • Measures patient satisfaction. PTPN Outcomes Program compares providers to national benchmarks for: • Effectiveness • Efficiency • Patient satisfaction Does actual performance significantly surpass national norms? YES Therapist receives incentive NO No incentive paid With the PTPN Outcomes Program, you know which therapists produce superior outcomes for your members. You can use this data to identify and reward Continued on other side. PTPN is the nation’s first and largest network of independent rehabilitation practitioners. For more insights, please visit ptpn.com and click on Payers Enter. In This Issue: Measuring REAL Provider Performance 26635 West Agoura Road, Suite 250 • Calabasas, CA 91302 800-766-PTPN • ptpn.com NATIONAL HEADQUARTERS: First Class Presorted U.S. Postage PAID Canoga Park, CA Permit #451 From PTPN, the rehabilitation and workforce productivity experts the offices and the networks that actually deliver on the promise of outstanding quality care. Rewarding real success: How it works Each quarter, the PTPN Outcomes Program compares providers’ performance to national norms for treatment effectiveness, efficiency and patient satisfaction. If an office’s quarterly scores for a payer’s patients is statistically better than the national norm (in other words, significantly above average), the office receives an incentive. If results are not significantly better than the norm, no incentive would be paid. PTPN’s program truly delivers on the promise of outcomes measurement and pay-for-performance. You will: • Improve quality of patient care. • Reduce your overall costs in the long run. • Know that the therapists in your network are the most efficient. • Reward the best therapists. To schedule a demo of the PTPN Outcomes Program and learn how it can help your bottom line, contact Lisa Burroughs at [email protected] or 800-766-PTPN. 1 “California Health Plans Pay $65 Million to Improve Performance in Patient Care,” Integrated Health Care Association (IHA), February 27, 2008 2 Terry, K., “Is P4P Getting Tougher?” Medical Economics, July 20, 2007. 3 “Big Money: Cost of 10 Most Expensive Health Conditions Near $500 Billion,” AHRQ News and Numbers, Jan.23, 2008. 4 FOTO is the oldest and largest outcomes reporting service in the United States, with an active comparative database of more than 2 million cases in just the last two years. Backed by the magnitude of its standardized database, FOTO produces the most accurate and validated results. This information is provided by PTPN, the nation’s first and largest outpatient rehabilitation network. All PTPN providers must be independent practitioners who own their own practices. PTPN’s network includes more than 1,200 therapist offices throughout the United States. PTPN is the first national therapy network to mandate an independent outcomes measurement program. WITH NETWORKS IN: Arizona • California • Colorado • Florida • Georgia • Louisiana Maine • Maryland • Massachusetts • Michigan • Mississippi • Missouri New Hampshire • New Jersey • New York • Ohio • Oklahoma • Pennsylvania Rhode Island • Tennessee • Texas • Vermont • West Virginia COPYRIGHT © 2008 PTPN Continued from front side.