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Health Net and the Connecticut State Medical Society-IPA Announce Pay for Performance Program for 2005

Posted on: Thursday, 21 July 2005, 09:01 CDT

Health Net of Connecticut and the Connecticut State Medical Society-Individual Practice Association (CSMS-IPA) today announced a new program that will promote improved quality of care. Called the Health Net and CSMS-IPA Partners for Quality (P4Q) program, the initiative will reward eligible physicians for providing quality, cost-effective care.

The P4Q program represents a collaboration between physicians and the health care industry. The program is differentiated from other regional programs in that it includes both primary care providers and specialists. In addition, it provides eligible physicians with an opportunity to earn bonus compensation beyond their current fee-for-service reimbursement.

"The P4Q program's primary goal is to reward physicians based on their ability to deliver quality, cost-effective care," said Steven H. Nelson, president, Health Net of the Northeast. "The program rewards pre-emptive action in areas such as diabetes treatment, breast cancer screenings and childhood immunization rates. This will promote higher quality health care for Health Net members and reward physicians who emphasize preventive medicine."

Health Net and the CSMS-IPA believe that P4Q will demonstrate to local employers, patients and accredited organizations their commitment to quality and cost-effective care.

"Physicians with superior performance compared to their peers will have an opportunity to be recognized for bonus payouts -- it is as simple as that," said David D. Thompson, Jr., M.D., president, CSMS-IPA. "P4Q includes realistic measures and allows top performing physicians to differentiate themselves and share best practices among their colleagues."

The CSMS-IPA and Health Net expect the P4Q program to evolve in future years. They anticipate that the program will be refined and measures expanded as the program matures, physicians provide additional comments, and as national standards emerge. The first measurement year covers 2005, with the first bonus payout expected in the second quarter of 2006.

"This agreement can go a long way toward aligning incentives and establishing a better working relationship between physicians and insurers," said Dr. Thompson.

"Partners for Quality gets us all on the same page in the chapter headed: Raising standards and managing costs," Nelson added.

About Connecticut State Medical Society - Individual Practice Association

The Connecticut State Medical Society - Individual Practice Association (CSMS-IPA) has approximately 7,000 physician members throughout the State of Connecticut. The CSMS-IPA was founded in 1986 and has maintained an open panel for any qualified physician. The IPA is the largest IPA in Connecticut and one of the largest in the nation. The Connecticut State Medical Society is the sole shareholder, and the CSMS-IPA is governed by a 27-member physician Board of Directors.

For more information on the CSMS-IPA, please visit the organization's Web site at www.CSMS-IPA.com.

About Health Net

Health Net of the Northeast, Inc., headquartered in Shelton, Conn., employs approximately 1,800 associates in Connecticut, New Jersey and New York. Health Net of the Northeast, through its subsidiaries, offers full-service health plans that serve nearly one million members in the tri-state area. The Northeast health plans offer a wide array of products including: Health Maintenance Organization (HMO), Point-of-Service (POS), Preferred Provider Organization (PPO), third-party administration, Medicare and Medicaid. With a physician network comprising more than 90,000 physician and provider office locations, Health Net is one of the largest health plans in the northeast, offering a full array of open-access products and coordination for multi-region employers.

Health Net of the Northeast is a subsidiary of Health Net, Inc. (NYSE:HNT). Health Net, Inc. is among the nation's largest publicly traded managed health care companies. Its mission is to help people be healthy, secure and comfortable. The company's HMO, POS, insured PPO and government contracts subsidiaries provide health benefits to approximately 6.5 million individuals in 27 states and the District of Columbia through group, individual, Medicare, Medicaid and TRICARE programs. Health Net's subsidiaries also offer managed health care products related to behavioral health and prescription drugs, and offer managed health care product coordination for multi-region employers and administrative services for medical groups and self-funded benefits programs.

For more information on Health Net, Inc., please visit the company's Web site at www.healthnet.com.

Cautionary Statements

Certain matters discussed in this release contain forward-looking statements within the meaning of Section 21E of the Securities Exchange Act of 1934, as amended, and Section 27A of the Securities Act of 1933, as amended, that involve a number of risks and uncertainties. All statements, other than statements of historical information provided herein, may be deemed to be forward-looking statements. These statements are based on management's analysis, judgment, belief and expectation only as of the date hereof, and are subject to uncertainty and changes in circumstances. Without limiting the foregoing, the words "believes,""anticipates,""plans,""expects,""may,""should,""could,""estimate,""intend" and other similar expressions are intended to identify forward-looking statements. Actual results could differ materially due to, among other things, rising health care costs, negative prior period claims reserve developments, trends in medical care ratios, issues relating to provider contracts, operational issues, health care reform and general business conditions. Additional factors that could cause actual results to differ materially from those reflected in the forward-looking statements include, but are not limited to, the risks discussed in the "Risk Factors" section included within the company's most recent Annual Report on Form 10-K filed with the SEC and the risks discussed in the company's other periodic filings with the SEC. Readers are cautioned not to place undue reliance on these forward-looking statements. The company undertakes no obligation to publicly revise these forward-looking statements to reflect events or circumstances that arise after the date of this release.

Source: Business Wire

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