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Blue Shield of California Awards $31 Million in Pay-for-Performance Programs

August 13, 2007

As part of its ongoing efforts to promote high quality affordable health care, Blue Shield of California announced today that it is awarding $31 million in bonuses to medical groups and IPA's in California linked to performance. Nearly half of the payments are part of the Integrated Healthcare Association (IHA) pay-for-performance program which rewards providers for the quality of their health care services, including clinical care, patient experience and use of information technology, based on criteria developed by the IHA.

Blue Shield uses the IHA standards to track physician organization performance on a range of clinical factors, including the immunization status of children in their care, control of HbA1c levels for patients with diabetes, and use of appropriate medications by those with asthma. By tracking performance and rewarding positive results, Blue Shield and other pay-for-performance health plans aim to encourage the use of best medical practices across the state.

"Blue Shield's mission is to provide Californians with access to high quality health care at reasonable prices," said David Joyner, Blue Shield's senior vice president, network management. "By giving health care providers financial incentives to increase performance on these critical metrics, we hope over time to make a positive impact on how medicine is practiced in California."

The IHA recently announced statewide results indicating that efforts by Blue Shield and other health plans to reward performance, particularly on the use of information technology, has paid dividends in improved patient care. According to IHA's tracking, medical groups that meet the standard for IT use also show significant improvement in clinical results, with an average 18 point difference between clinical scores for groups that use information technology effectively and those that do not.

Background on Blue Shield of California

Blue Shield of California, an independent member of the Blue Shield Association, is a not-for-profit health plan dedicated to providing Californians with access to high quality care at a reasonable price. Founded in 1939, it now has 3.2 million members, 4,500 employees, one of the largest provider networks and more than 20 office locations, providing a wide range of commercial and government products throughout the state. The company contributes $30 million annually to the Blue Shield of California Foundation to fund nonprofit organizations that improve access to quality health care in California.

Contact your local agent or broker for more information about Blue Shield products and services, or visit the Blue Shield web site at