Medica’s Pay for Performance programs are designed to assess the efficiency and quality related to focused areas of clinical care provided to Medica members by practitioners in the Medica network. These programs are also intended to provide financial rewards to those providers driving care improvements and achieving evidence-based outcomes. These programs were created based on provider feedback about costs of improving care and employer/state concerns about health care costs. Programs included are the Performance-Based Incentive program (PBI) and the Choice Care Quality Improvement program (CCQI).
Both programs have the following in common:
- Current program year measurements relate to the preavious year (Example: Program year 2007 measurements are completed in 2008 and based on 2007 dates of service)
- Program communication and report format
- Program reporting and payout occurs in the fourth quarter of each measurement year (based on previous year’s dates of service)
- Groups are identified by federal tax ID and/or contracted groups with multiple federal tax ID numbers, depending on the group and measure.
Further criteria for eligibility are defined by each measure.
The tables and descriptions that follow differentiate some of the unique details of each program.
View the Medica Pay for Performance Cycle Overview
2008 Program Measures
Performance-Based Incentives
Choice Care Quality Improvement program
2007 Program Measures
Performance-Based Incentives
Choice Care Quality Improvement program
2006 Program Measures
Performance-Based Incentives
Choice Care Quality Improvement program
2005 Program Measures
Performance-Based Incentives
Choice Care Quality Improvement program