Doctors have found a way to get a pay raise from health insurers and keep patients happy at the same time: Practice better medicine. This year, six of Colorado's largest physician-practice associations will get bonus checks from Anthem Blue Cross Blue Shield as part of a pilot program tracking how well doctors perform.

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Bonuses are based on how well the 1,095 doctors do at things like lowering patients' blood pressure or controlling their diabetes.

While neither Anthem nor the physicians would disclose the exact bonuses, the payout for five of the medical groups totals $504,120 for 2004 performance, according to Anthem.

The sixth group, Centennial-based MedSouth, chose to take its bonus in the form of an overall pay raise - about 4 percent, said Amy MacMillan, an Anthem project manager.

In the health care industry, financially rewarding doctors for quality care is a new and sharp departure from past reimbursement practices.

Health plans rewarded doctors for delivering the most medicine for the least amount of money, said Dr. Ken Cohen, medical director of Golden-based New West Physicians.

"There was such a backlash," Cohen said. "Paying for quality is a major stride forward."

A study in Wednesday's Journal of the American Medical Association said paying for performance is a growing trend. "Pay-for-performance has significant potential to improve the performance of the health care system," said Meredith Rosenthal, assistant professor of health economics and policy at Harvard's School of Public Health and the article's author.

In 2004, 35 health plans covering 30 million patients offered pay-for-performance programs, according to The American Academy of Family Physicians.

The academy projects that to rise to at least 80 health plans covering 60 million members by 2006.

Medicare, the federal program covering 42 million elderly and disabled, also has a demonstration pay-for-performance pilot underway.

"It was slow getting off the ground," said Dr. Arthur Klein, chief operating officer of New York Presbyterian Hospital. "I think you are going to see a rapid proliferation."

Klein co-chairs a task force on pay-for-performance contracting for the National Committee for Quality Health Care.

The JAMA study noted, however, that most programs are still new and unproven.

In 2003, for example, California doctors in a pay-for-performance program sponsored by PacifiCare Health Systems outperformed non-participating physicians in Oregon and Washington by only one measure: cervical cancer screening.

Still, the California physician groups earned bonuses between $360,155 and $436,618, researchers found.

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Source: Denver Post