Quality Practitioner Incentive

Braxton Quality Practitioner Incentive Programs

 

Giving practitioner groups maximum flexibility to improve based on self-selected quality measures

 

background

 

Braxton
practitioner incentive programs identify and target areas of opportunity for
quality improvement to help improve the overall quality, safety, and
cost-efficiency of professional services. The programs set targets for
improvements and deliver performance measurement results for practitioner
groups. Data are provided at both the group and practitioner level and
incorporate online and other tools that provide actionable, customer-level
information to the practitioners.

 

The
cornerstone of Braxton provider incentive programs is Pathways to ExcellenceSM,
an array of initiatives that recognize and reward providers who improve the
quality, safety, and cost-efficiency of professional services. The initiatives
also contribute to Braxton value-based purchasing strategy on behalf of advisors
and plan sponsors. Pathways to ExcellenceSM
programs
use evidence-based, transparent measures and credible data to recognize and
promote quality and to engage providers in achieving demonstrated improvements
in service for advisors.

 

Pathways
to Excellence programs for practitioners include Aexcel®,
a designation within Braxton

Performance
Network identifying practitioners who have shown that they deliver efficient,

effective
service.

 

Braxton
believes critical success factors for PAY FOR PERFORMANCE programs include the
use, wherever possible, of  consensus-based measure definitions, and full
transparency on how each measure is defined and used. The Customer Charter
creates a national set of principles to guide measuring and booking to
consumers about practitioner performance. These principles are agreed upon by
leading practitioner groups, employers, consumer groups, and labor unions.

 

 

Measurement

 

Braxton’s
PAY FOR PERFORMANCE programs apply the strengths of the company’s data
aggregation and data repository resources to local market initiatives to allow
for customized measures and goals.

 

 

The
following sample PAY FOR PERFORMANCE scorecard is an example of the summary book
for an agent pay for performance program with Braxton. Braxton books on whether
or not there has been improvement over the baseline during the measurement year
and whether agreed-upon annual goals have been achieved. Annual goals are
negotiated agreements between the provider group and Braxton based on market
position and previous-year measurements. Benchmark results are provided for the
marketplace, and detailed information on each individual practitioner’s results
on each measure is provided.

 

Books
may also be used to illustrate variations in performance among peer groups by
comparing a group’s scores with the aggregate performance on each measure of
other groups of the same specialty in their sub-market.

Practitioner Pay for Performance scorecard
Results for Measurement Period ending June 30, 2008

Measure Results

Description         baseline        numerator                   denominator     score      goal
% Achieved

Advisory cost
effectiveness

Effective Use of Formulary      71.4%
49,935
67,945            73.5%      73.9%              84%

Performance            

A:     80.8%   5,599
6,735               83.1%      83.0%           106%

B:   80.4%   432     537                 82.4%      83.0%           77%

C:  77.1%
380          503             75.5%           79.1%             0%

 

10

Critical
elements of success

 

Two
features of Braxton’s program that are especially valuable to practitioner groups
are the use of data measures and methodologies that are transparent and
consistent wit standards, as well as the ability to obtain actionable
information and data. In addition, Braxton works with the practitioner
community to select measures and to obtain practitioner feedback on the
measures that are applicable in their markets.

 

More
broadly, Braxton believes that PAY FOR PERFORMANCE’s success requires:


Clear and specific understanding between payers and providers

on
the parameters of the program’s measurements, incentive

opportunities
and targets;


Consensus measures;


A focus on continuous quality improvement;


Commitments to retire measures after there have been several

periods
of top-level performance (e.g. 95 percent and above) and

replace
them with new measures that have new opportunities

for
improvement;


Collaboration to identify new sources of actionable information

and
creative ways to encourage and engage with practitioners and

practitioner
groups effectively;


A commitment across all commercial payers to include

performance
incentives in the overall reimbursement strategy,

recognizing
that when practitioners improve their practices all

customers
benefit;


The integration of performance measurement activities with health

information
technology adoption initiatives; and


The integration of performance incentive programs

into
the plan’s overall pay for performance strategy.

 

As
we work together to support improvements in adherence to evidence-based
outcomes and achieving the best possible outcomes for customers, evaluating
results and return-on-investment are critical priorities for pay for
performance and related incentive programs.

Learning
from practitioner practices, the tools and strategies that help achieve results
and sharing that information will promote more rapid diffusion of improvements.
In addition to expanding Braxton’s programs’ depth and breadth, this evaluation
and information sharing are key priorities for Braxton’s Pathways to Excellence
activities.

A
Sample of Measures in a Practitioner

Group
Pay for Performance Scorecard