Health insurance provider Aetna has entered into a pay-for-performance (P4P) contract with the New York University (NYU) Medical Center. Under a new “hospital services compensation schedule,” Aetna will financially reward NYU Medical Center for superior performance and/or continuous improvement on nationally recognized measures of patient safety and quality of care, as well as mutually agreed upon measures for efficient delivery of medical services.
If successful, the payor said the P4P pilot is intended to serve as a model for future Aetna hospital contracts in the New York market.
For the Aetna/NYU Medical Center pilot, 50 percent of the criteria are derived from established quality benchmarks employers use to evaluate health plan performance, and which have been adopted by the U.S. Centers for Medicare and Medicaid Services; 30 percent involve clinical performance measures, such as length of stay and hospital readmission rates; and the final 20 percent are based on patient-safety yardsticks developed by the Leapfrog Group, a business consortium representing 34 million employees from Fortune 500 and other companies.
The P4P pilot will extend for a little more than three years. Aetna and NYU Medical Center both intend that continuous improvement will be made in each year of the program and for that reason performance goals and specific performance measures may be adjusted to reflect progress already achieved. Financial incentive payments will also vary from year to year based on the performance criteria being measured, Aetna said.