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Published on: February 16, 2011
Economic grand rounds: A pay-for-performance program for behavioral health care practitioners
Anthony L Pelonero1, Richard L Johnson
1Anthem Blue Cross and Blue Shield of Virginia, Mail Drop VA4003-M000, 2221 Edward Holland Dr., Richmond, VA 23230, USA. anthony.pelonero@anthem.com
Psychiatric Services (Washington, D.C.)
|April 7, 2007
Summary
A pay-for-performance program incentivizes behavioral health practitioners to improve care quality. It aims to recognize high-quality providers and align practices with national standards, benefiting patients and purchasers.
Area of Science:
- Health Services Research
- Behavioral Health Quality Improvement
Background:
- Pay-for-performance (PFP) programs are increasingly used in healthcare.
- Behavioral health care quality improvement is a critical area for health insurers.
Purpose of the Study:
- To describe a pay-for-performance program for behavioral health care practitioners.
- To outline the goals of improving care quality, recognizing high-performing providers, and demonstrating value.
Main Methods:
- Implementation of a PFP program by a national health insurer in 1996.
- Focus on developing clinically meaningful and fair quality measures.
- Consideration of measure applicability across disciplines and data collection feasibility.
Main Results:
- The program aims to recognize practitioners providing higher-quality care.
- It seeks to align provider practices with national standards.
- Future goals include empowering patients with provider quality data for treatment decisions.
Conclusions:
- Effective PFP programs require careful measure development.
- Considerations include measure applicability, data collection, clinical meaningfulness, fairness, and variability.
- Such programs can enhance behavioral health care quality and demonstrate its value.
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