Printer FriendlyHEALTH PLAN, PHYSCIANS COLLABORATE TO DEFINE QUALITY PEDIATRIC CARE
Effort by UHA and the Hawaii Chapter of the American Academy of Pediatrics Wins National Recognition
(HONOLULU, October 15, 2007) — The American Academy of Pediatrics, AAP, has recognized The Hawaii Chapter of the AAP (HAAP) and Hawaii health insurer UHA for an innovative collaboration to measure quality pediatric preventive health examinations. The Special Achievement Award was presented to HAAP President Galen Chock, M.D. at the AAP District VIII meeting in Portland, Oregon, in September.
As part of the collaboration, pediatricians with HAAP recommended effective preventive procedures in pediatric examinations. Working with the pediatricians, UHA then developed a tool to measure use of the procedures. Recognizing the value of promoting these quality procedures and the subsequent monitoring of its providers' performance, UHA pays its providers an additional amount for completing the tool. Data collected will help UHA document the effectiveness of preventive care and will also help UHA and its providers identify children at risk for serious conditions such as childhood obesity.
"The benefits of this kind of collaboration are enormous for all of us," said Max Botticelli, M.D., chief executive officer of UHA. "Excellent preventive care can identify illnesses before they become life-threatening or chronic. The health of our children will improve with a system of recognized preventive care, and health care becomes much more cost effective."
"The UHA Pediatric Health Screening program and data collection is the product of thoughtful pediatric input and health plan initiative which recognizes that optimal child health involves important screening by pediatric health care providers. No other Hawaii health plan has taken this degree of commitment towards demonstrating the importance of this facet of health care for children and has been so willing to listen to the pediatric community," said Chock. "HAAP has been working to build partnerships throughout the community to improve child health care in Hawaii. We are pleased that UHA has been willing to work with us in doing just that."
The Pay-for-Performance system, or P4P, is being used by large self-insured employers to control overuse of health care services by shifting physician and hospital payments from the number of services provided to the quality of health care delivered. Aware that a Pay-for-Performance structure would not work without a method of measuring performance, HAAP developed the screening guidelines and then UHA developed a measurement tool based on those guidelines.
The UHA Pediatric Health Screening program was first introduced in February to a select group of pediatricians who tested the program. The program was then opened to all HAAP member pediatricians in August. UHA will now offer this program to all participating primary care physicians who provide health care services to UHA members.
The screening tool includes categories identified as critical by the AAP, including the calculation of Body Mass Index (BMI) percentiles, an early indicator of childhood obesity. "Calculating BMI percentiles are not a compensated service under other health plans," said Chock. "Yet, if left untreated childhood obesity can lead to chronic illnesses such as diabetes and high blood pressure."
"Good preventive health care takes time and effort and physicians should be paid for that time and effort," said Botticelli. "HAAP put a huge amount of thought into this screening tool, and it's outstanding. We at UHA look forward to more collaboration with our physician providers. If all parties work together, we can provide the people of Hawaii with excellent care without breaking the bank."
Founded by a group of physicians in 1996, UHA is dedicated to providing access to quality health care services while protecting its members from financial loss due to illness or injury. UHA provides competitively priced medical, drug, and vision plans to more than 2,000 employers. With more than 40,000 members, UHA is the third-largest commercial health insurer in Hawaii.
