Specialty Care Incentive Matrix

Due to the success of the PCP Incentive Matrix, in July of 2016 COIPA expanded our incentive program to the specialty care providers in Central Oregon and the Columbia Gorge. A new committee of specialty care providers was formed, and they wrestled with the difficulty of creating a matrix of incentive measures that was relevant across the dozens of highly disparate subspecialties in our region. They selected measures in three areas:

  • Access: Because access to specialty care is so important to all patients, especially those enrolled in Medicaid, in order to include access measures in the matrix, we divided providers into two groups: those who control access to their services (most specialties) and those who do not (radiologists, anesthesiologists, pathologists, hospitalists, and providers in emergency medicine or urgent care). For the former group, we will be collecting data on the realities of access for OHP patients seeking all types of specialty care.
  • Quality & Cost:
    • Care coordination: Most specialty care requires coordination among several providers. We are incentivizing use of secure, HIPAA-compliant messaging between providers in order to improve care coordination across a patient’s entire treatment team
    • One of the few factors that influence patient outcomes no matter the condition addressed by a specialist is tobacco use. For our access-relevant specialties, we would like to increase rates of tobacco use screening across all specialty providers.
  • Specialty-Specific Measures: The lynch-pin of the Specialty Incentive Matrix, each participating provider will select measures that are relevant to their specialty, evidence-based, and relevant to the Medicaid population. This allows providers to measure aspects of their patient care that they find truly meaningful and clinically relevant to the outcomes for their patients.
    • Due to the difficulty in collecting data and reporting on a new measure, we have separately incentivized the steps involved for each quarter (planning, workflow changes, staff training, report building, etc), and providers will not begin reporting on their selected measures until summer 2017.

Click here for more details about the Specialty Incentive Matrix 

The Specialty Incentive Matrix program is a cutting-edge attempt to replicate the successes of many PCP quality incentive programs in a group with very disparate patient demographics, treated medical conditions, outcomes, intervention levels, and clinical environments. To our knowledge, there are currently very few groups in the United States who are attempting to create a program like this and possibly we are the only group attempting this across all subspecialties. We are very excited to launch this program in the third quarter of 2016. Check this page again in the fall to see the results of our inaugural Specialty Incentive Matrix!

If you have questions about the Specialty Incentive Matrix or are interested in participating, please contact Ashley Zeigler: azeigler@coipa.org 541-280-8166