UCare’s Pay for Performance (P4P) program paid $2,160,750 to clinics and care systems across Minnesota for their performance in key quality-of-health measurements achieved in 2009.
The payments recognized and rewarded providers for superior or improved performance in measurable key areas for care delivered to members of UCare’s Minnesota Health Care Programs (MHCP), including MinnesotaCare and Prepaid Medical Assistance Program (PMAP), UCare’s Minnesota Senior Health Options (UCare’s MSHO), and to members of UCare’s UCare for Seniors Medicare Advantage plan.
Dr. Russ Kuzel, Senior Vice President and Chief Medical Officer, says UCare’s Pay for Performance program rewards providers of all sizes who show superior or improved performance in key quality-of-health measures for UCare members.
“We are pleased to recognize our providers for their performance,” Dr. Kuzel says. “The improvement in the measures benefits our members through better preventive care and monitoring of their chronic conditions.”
For results achieved in 2009, UCare made P4P payments to:
1. 546 eligible care systems and independent clinics serving MHCP members. Total MHCP payments were $1,390,800.
2. 365 eligible care systems and independent clinics serving members of UCare for Seniors Medicare Advantage plan. Total Medicare payments were $696,450.
3. 109 eligible care systems and independent clinics serving members of UCare’s MSHO. Total MSHO payments were $73,500; 2009 was the first year UCare included MSHO in the P4P program.
The top five clinics receiving P4P payments for Medicaid are:
1. University of Minnesota Physicians .
2. Children’s Physician Network.
3. Neighborhood Health Care Network.
4. Minnesota Healthcare Network.
5. Fairview
Physicians Network.
The top five clinics receiving P4P payments for Medicare are:
1. Fairview Physicians Associates.
2. Family Health Services of Minnesota.
3. Park Nicollet.
4. North Clinic.
5. North Memorial.
The top five clinics receiving P4P payments for UCare’s *MSHO* are:
1. University of Minnesota Physicians.
2. Fairview Physicians Network.
4. HealthEast.
“All providers in the UCare network are eligible for P4P payments,” Dr. Kuzel continues. “We reward providers with results above the 60th percentile threshold; there’s no ‘all or none’ approach. Any clinic or care system posting improvements over the previous year’s performance also is rewarded, although these payments are one-half of the payments made to clinics above the 60th percentile threshold.”
UCare will continue to recognize and reward superior performance and improvements by MHCP, UCare’s MSHO, and Medicare providers of all sizes.
UCare (www.ucare.org) is an independent, nonprofit health plan providing health care and administrative services to more than 200,000 members. UCare partners with health care providers, counties, and community organizations to create and deliver innovative health coverage products for:
Individuals and families enrolled in income-based Minnesota Health Care Programs, such as MinnesotaCare and Prepaid Medical Assistance Program. – Adults with disabilities and Medicare beneficiaries with chronic health conditions. Minnesotans dually eligible for Medical Assistance and Medicare. Medicare eligible individuals throughout Minnesota and in western Wisconsin.
UCare addresses health care disparities and care access issues through its UCare Fund grants and a broad array of community initiatives. The health plan received a Top Workplaces 2010 honor from the Star Tribune.
