Business

Database to aid quality efforts

A California organization is implementing the project to help medical groups crunch more timely data for bonus and other programs.

By Tyler Chin — Posted Dec. 13, 2004

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The California Assn. of Physician Groups is planning to build a clinical data repository in an effort to offer its members a tool to benchmark quality, lower costs and ensure that they collect quality bonuses from insurers.

CAPG, which represents 149 large physician groups and independent physician associations, plans to launch the database as early as January 2005. Eleven physician groups and IPAs have committed to provide patient data in 2005 to the project, which will be expanded to other entities in 2006, said Donald Crane, CAPG's president and CEO.

Health, laboratory, pharmacy claims data and laboratory values are among the data that will be collected and analyzed. Individual groups will be able to access identifiable data of their patients, but not other groups' patients except for anonymous benchmark data, Crane said.

A major reason CAPG is undertaking the initiative is to better serve the needs of its members. Several of them already use information technology to collect and analyze their clinical data but can't benchmark themselves against peers because they lack access to data from other physician groups, said Douglas Allen, MD, chair of the CAPG committee developing the data repository. The project also will benefit groups that don't have data repositories, he said.

Another reason driving the project is that several CAPG members are participating in an initiative called Pay for Performance. Those physician groups need a data collection and analysis tool to help ensure that they meet the initiative's criteria to get an annual quality bonus payment.

In October, six insurers gave out approximately $50 million in bonuses to groups that participated in the year-old Pay for Performance project run by Integrated Healthcare Assn.

The Pay for Performance initiative provides benchmarking data to participants. But they receive those data about nine months after the program ends every Dec. 31.

"That whole year of performance doesn't get reported internally for the medical groups that participated until September," Dr. Allen said. "If you find [out in September] that you're slipping behind the curve, it's too late to create and fund a disease management program and then actually show improvement in that last three months of the [current] year."

The data repository will cost $4 million to $5 million. CAPG is seeking funding primarily from health plans. The project also will be funded and maintained by annual fees of up to $20,000 from participating physician groups and IPAs, Crane said.

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