Record Detail

PROGRAM SPONSORSHIP Formal name of the incentive and/or reward program initiative (if applicable) Program name Duke Prospective Health Program sponsor(s) and parent organization of sponsor(s), if applicable Program sponsor(s) Duke University and Health System Primary program contact information Name Jane Walbrun Title Health Plan Manager Organization Duke University Email jane.walbrun@duke.edu Phone 919-681-4668 Sponsoring organization type Employer(s) Single employer Source of funding associated with program set-up costs Funding source Funded by program sponsor(s) Percent contributed by sponsor and grant organization % Sponsor 100 Program set-up costs 500000 Source of funding associated with program operations costs Funding source Funded by program sponsor(s) Percent contributed by sponsor and by grant organization % Sponsor 100 Program operations cost 1700000 Start date & end date of the program Start Date 01/01/2004 End ongoing   PROGRAM SCOPE Geographic scope of program North Carolina Individuals affected by program as a percentage of total population, if known Employer/commercial health plan- active workers (indicate %) 55 Employer/commercial health plan- dependents (indicate %) 45 Coverage of affected individuals (for purchaser sponsors only) HMO Direct target(s) of your program's incentives/rewards Hospital type Academic hospital(s)- American Association of Medical Colleges (AAMC) member(s) Hospital unit System Physician type PCPs Physician unit Independent Physician Association (IPA) Consumers- employer covered lives (for employer respondents only) Salaried employees Hourly employees Union Non-union Full-time Part-time Dependents Recruitment of program targets Voluntary with no penalty for non-participation PROGRAM PERFORMANCE MEASURES Outpatient clinical and safety measures included in the program Measure sources HEDIS (clinical components) Measurement areas Other measurement areas Diabetes Hypertension Adult Preventive Care Pediatric Preventive Care Resource Utilization and Cost Resource utilization Average length of stay (ALOS) Emergency room (ER) visits Re-admission rates Cost Total cost in Episode Treatment Groups (ETGs) Health plan performance measures Health plan measures Cost/efficiency measures Performance measure weighting Clinical performance % or N/A 100 Consumer measures Enrollment and/or participation in risk reduction program Health risk appraisals Nutrition/weight management Physical activity Smoking Stress management Other Specify consumer education Enrollment and/or participation in risk management program Cardiovascular disease Diabetes Provider choice Chooses high-performing physicians, Chooses high-performing hospital Data Reliability Sources of data Existing or new data Existing data sources, New data collected explicitly for program reporting Data type Administrative in origin (derived from claims data) Medical record data Self-reported Data extracting entity Independent entity Data aggregator/analyzer Independent entity Ensures data accuracy No Risk-adjustment mechanisms used None of the above INCENTIVE/REWARD CHARACTERISTICS Start date & end date of the incentive/reward Start Date 01/01/2004 End Date ongoing Structure of the incentive or reward Direct financial reward- increased payment Lump-sum bonus Indirect financial reward Publicize good performance Target audience for publication of performance To provider peers Upper reward limit $200,000 (among all physicians and all groups) Structure of the incentive or reward for programs targeted at consumers Financial reward - direct Cash reward or reward of monetary value Specify dollar amount $25. Average monetary consumer incentive $100 Scoring used to determine payment Absolute goals- patient level measures Pay for meeting specific sub goals related to overall measure/group of measures Absolute goals- population level measures Pay for meeting specific sub goals related to overall measure/group of measures Frequency of reward or penalty Annually Time lag between measurement and receiving reward/penalty Other Specify variable Total dollar amounts awarded during the most recent calendar year 170000-provider, 300000 -consumer Source of financial payments for meeting performance goals Current budget redistributed New funding -internal COLLABORATION CHARACTERISTICS Phases of program where sought target collaboration Program design and creation Did not seek collaboration Characteristics of pre-implementation target feedback Provider participation in program design Receives compensation for administrative burden of data collection No Characteristics of post-implementation target feedback Incentive target groups/individuals given comparative information Information provided on how results will be used Mechanism to consider additional information and communicate back to target Process available for target to provide additional information and/or corrections Blinding of performance feedback with targets Confidential Frequency of performance feedback to the targets Semi-annual PROGRAM EVALUATION How the program evaluates its success Improvements in clinical performance Improvements in health status of population Sponsor financial return on investment (ROI) Evaluator Independent entity Specify consultant Additional results of program evaluation early indication of return on investment. reduced utilization in target groups Lessons learned from designing and implementing the program plan sufficient start up time engage existing resources adequately fund marketing

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