More than $2 million paid to providers improving the health of UCare’s Medicare, Medicaid, and
Minnesota Senior Health Options (MSHO) members.

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:

546 eligible care systems and independent clinics serving MHCP members. Total MHCP payments were $1,390,800.
365 eligible care systems and independent clinics serving members of UCare for Seniors Medicare Advantage plan. Total Medicare payments were $696,450.
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:

Fairview Physicians Associates.
Family Health Services of Minnesota.
Park Nicollet.
North Clinic.
North Memorial.
                                                              

The top five clinics receiving P4P payments for UCare’s MSHO are:

1.    University of Minnesota Physicians.

2.    Fairview Physicians Network.

3.    Mayo Health System.

4.    HealthEast.

5.    St. Mary’s Duluth Clinic.

Details about UCare’s P4P program

“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.”

 For UCare’s state public program population in Minnesota, 2009 P4P payments were made based on the achievement of goals for:

Well child visits for children age 3-6 years.
Well child visits for children age 12-21 years.
Colon cancer screening.
Two-year-olds up-to-date on immunizations.
Blood lead testing.
Diabetes care.
Breast cancer screening.
Chlamydia screening.
 

For UCare for Seniors Medicare Advantage and UCare’s MSHO members, P4P payments in 2009 were made based on the achievement of goals set for:

Colon cancer screening.
Breast Cancer Screening.
Diabetes care.
Cardiovascular disease care.
 

UCare will continue to recognize and reward superior performance and improvements by MHCP, UCare’s MSHO, and Medicare providers of all sizes.