| Orthopedic and Neurological Surgeon Quality Pilot |  | |
About
With input from Washington surgeons, L&I developed the Orthopedic and Neurological Surgeon Quality Pilot (“the pilot”) as a pay-for-performance initiative to improve workers’ access to high quality surgical care. Surgeons participating in the pilot receive incentive pay for demonstrating high quality and efficient patient care.
To determine the appropriate level of incentive pay for individual participants, every 6 months L&I’s pilot team assesses each surgeon’s aggregate performance on a set of 6 quality indicators. Surgeons meeting or exceeding all performance thresholds are eligible for Tier 3 incentive pay (the highest level), while those who are unable to meet minimum thresholds risk losing incentive pay privileges.
To download a one page visual summary of enrollment, tier assignment, and incentive pay view the following flow chart in PDF.
Pilot participants
Orthopedic, neurological, and hand surgeons were invited to join the pilot for participating in some or all of these cooperative quality improvement efforts:
- Development of this pilot; or
- Participation in the Centers for Occupational Health and Education (COHE); or
- Utilization Review Program Group A providers.
The pilot began on July 1, 2006, with 34 surgeons from 8 clinics across Washington participating. As of April 2009, 226 surgeons from 47 clinics across the state are participating, and 71% of the surgeons are performing well enough to earn Tier 3 incentive pay. Since the pilot began, participating surgeons have treated more than 40,662 workplace injuries insured by L&I.
List of providers enrolled in pilot (142 KB PDF).
Evaluation
In 2009, the University of Washington will conduct an independent evaluation of the pilot, focusing on these anticipated results:
- Improved worker access to timely surgical care.
- Reduced administrative burden for physicians.
- Increased payment levels for high quality surgeons.
- Improved communication/coordination of care.
- Increased likelihood of timely rehabilitation and return to work.
The evaluation is projected to wrap up in March 2010. L&I will use evaluation findings to improve the design of the pilot and to link incentive payment to high quality surgical care more effectively.
Orthopedic & Neurologic Surgeon Quality Pilot: Participants Manual (version 5) (925 KB PDF)
November Issue of The Pilot Newsletter (210 KB PDF)
For more information about this pilot, contact the pilot team at ONSQualityPilot@LNI.wa.gov, or by phone at 360-902-6060.
