Sunnyvale Primary Care (SPC) is considering a P4P program to increase prevenativ
ID: 2815576 • Letter: S
Question
Sunnyvale Primary Care (SPC) is considering a P4P program to increase prevenative care for its diabetic patients. HbA1c is a blood test used to determine how well diabetes is being controlled. The state medical association recommends that diabetic patients have this test a minimum of two timer per year. In addition, beacuse patients regularly enter and leave primary care practices, the association considers that a level of 90 percent diaberic patients having HbA1c test two times per year is a reasonable goal for most primary care practices. In the state where SPC is located, currently only 80 percent of diabetic patients actually have a HbA1c test two or more times per year.
SPC decided on HbA1c as a process measure for its P4P program and is now considering three methods of allocating rewards. For each of the measures below, a physician recieves a $5,000 bonus if:
-the percent of their diabetic patients that had at least two HbA1c tests in the past year is greater than the state average of 80 percent (relative performance).
-the percent of their diabetic patients that had at least two HbA1c tests in the past year is greater than the state goal of 90 percent (benchmark performance).
-the difference in the percent of their diabetic patients that had at least two HbA1c tests in the past year compared to the previous year is greater than 10 percent (improvement performance).
The percent of diabetic patients that had at least two HbA1c tests in the past year for each SPC physician is shown below:
Physician Jan-Jun Jul-Dec
A 60% 76%
B 70% 81%
C 80% 81%
D 90% 91%
a) For the Jul-Dec period, what would be each physician's P4P if rewards were allocated based on relative, benchmark, and improvement performance?
b) Which method(s) of allocating rewards would you recommend?
Sunnyvale Primary Care (SPC) is considering a P4P program to increase prevenative care for its diabetic patients. HbA1c is a blood test used to determine how well diabetes is being controlled. The state medical association recommends that diabetic patients have this test a minimum of two timer per year. In addition, beacuse patients regularly enter and leave primary care practices, the association considers that a level of 90 percent diaberic patients having HbA1c test two times per year is a reasonable goal for most primary care practices. In the state where SPC is located, currently only 80 percent of diabetic patients actually have a HbA1c test two or more times per year.
SPC decided on HbA1c as a process measure for its P4P program and is now considering three methods of allocating rewards. For each of the measures below, a physician recieves a $5,000 bonus if:
-the percent of their diabetic patients that had at least two HbA1c tests in the past year is greater than the state average of 80 percent (relative performance).
-the percent of their diabetic patients that had at least two HbA1c tests in the past year is greater than the state goal of 90 percent (benchmark performance).
-the difference in the percent of their diabetic patients that had at least two HbA1c tests in the past year compared to the previous year is greater than 10 percent (improvement performance).
The percent of diabetic patients that had at least two HbA1c tests in the past year for each SPC physician is shown below:
Physician Jan-Jun Jul-Dec
A 60% 76%
B 70% 81%
C 80% 81%
D 90% 91%
a) For the Jul-Dec period, what would be each physician's P4P if rewards were allocated based on relative, benchmark, and improvement performance?
b) Which method(s) of allocating rewards would you recommend?
Explanation / Answer
Ans, To me prima facie it looks like some data is missing, if it is the case i sincerely request you to please mark it in the comment. I will try to make changes asap.
Neverthless on the basis of given data this is how solution looks like:
1. Relative Performance Reward method:
Physician A bonus will be Zero, as his % of patients (76%) is not breaching the 80% threshold limit
Physician B bonus will be 5000 $, as his % of patients (81%) has crossed the relative limit of 80%
Physician C bonus will be 5000 $, as his % of patients (81%) has crossed the relative limit of 80%
Physician D bonus will be 5000 $, as his % of patients (91%) has crossed the relative limit of 80%
2. Benchmark Performance Reward Method:
Physician A bonus will be Zero, as his % of patients (76%) is not crossing the 90% benchmark limit
Physician B bonus will be Zero, as his % of patients (81%) is not crossing the 90% benchmark limit
Physician C bonus will be Zero, as his % of patients (81%) is not crossing the 90% benchmark limit
Physician D bonus will be 5000$ , as his % of patients (91%) is crossing the 90% benchmark limit
3. Improvement Performance Reward Method:
Physician A bonus will be 5000 $, as his % of patients (76%) has increased by more than 10% over the Jan-Jun count of 60%
Physician B bonus will be 5000 $, as his % of patients (81%) has increased by more than 10% over the Jan-Jun count of 70%
Physician C bonus will be 0, as his % of patients (81%) has not increased by more than 10% over the Jan-Jun count of 80%
Physician D bonus will be 0, as his % of patients (91%) has not increased by more than 10% over the Jan-Jun count of 90%
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Total Payout in all the schemes will be:
b. In my opinion, the Improvement based P4P model is best because:
1. It truly rewards the increment in the no of patients covered i e how many more patients increased for a doctor
2. Based on this method, SCP can target SMA target of 90% very effectively as the physicians with lesser % of patients covered will be motivated to increase the count of their covered patients as they will be handsomely rewarded in the process.
3. The payout of the company will be moderate as well in this case.
Scheme Name Total PayOut Relative $ 15000 Benchmark $ 5000 Improvement $ 10000Related Questions
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