The payers are Aetna Inc., Highmark Inc., UnitedHealth Group and WellPoint Inc. All four insurers, at minimum, will align their pay-for-performance programs with federal meaningful use criteria. In some cases, physicians who meet a payer's P4P criteria and demonstrate meaningful use will receive a higher P4P payment; in other cases the payment won't rise but demonstrating meaningful use will become a criteria for getting the P4P payment.
Aetna will offer additional financial incentives for demonstrating meaningful use but whether the payments come from a separate incentive program or an increased P4P payment has not yet been determined.
UnitedHealth now will tie part of its P4P payments to demonstrating meaningful use. It is not yet clear if meeting meaningful use will result in a higher P4P payment. UnitedHealth has P4P programs in several regions across the nation. Now, it will rollout a single, uniform P4P program nationwide.
UnitedHealth also will designate on its consumer-focused physician directory the physicians who meet meaningful use criteria; the directory currently enables consumers to know if a physician meets certain criteria for quality and efficiency of care. The insurer's Physician Advocate Program, which offers practice management improvement consulting services, now also will aid practices in qualifying and applying for federal meaningful use incentives.
Physicians adopting the CareTracker EHR of the Ingenix subsidiary of UnitedHealth will receive additional consulting support. Further, through subsidiary Optum HealthBank, UnitedHealth will offer zero percent financing on CareTracker until a physician practice receives its federal meaningful use incentive payment.
At WellPoint, physicians in a P4P program will have to demonstrate meaningful use to get a payment, but meaningful use won't increase the payment. WellPoint also will offer millions of dollars in low-interest loans to assist hospitals in rural, critical access or medically underserved areas to purchase and adopt EHRs. The loans will start in California and Georgia in 2011, and WellPoint will use results from those programs to evaluate expansion to other states.
Details on Highmark's incentive program were not available.
In a joint statement, National Coordinator for Health Information Technology David Blumenthal, M.D., and Centers for Medicare and Medicaid Services' Principal Deputy Administrator Marilyn Tavenner, applauded the new initiatives of commercial payers. "The public and private sectors can and must collaborate in furthering the goal of creating a 21st Century electronic health information system in the United States."