home Not Logged In
pay-for-performance
OGM

OGM has over ten years of experience with Ob-Gyn pay for performance programs. During that time, our metrics have been specifically developed by practicing ob-gyn’s for the practicing ob-gyn. The backbone of our measurements is our unique constructs and our ability to attribute patients to specific doctors. Each physician’s performance is compared against that of his or her local peer group. Physicians that qualify for a bonus earn a separate payment determined by the number of patients under their care, adjusted for their absolute score. To be credible with the local physician community, we encourage input from local advisory boards on program structure, selection of available metrics, and scoring methodology.

OGM’s profiling metrics are built upon several unique data constructs:

  • Panel Members (“GYN Load”): A list or “panel” of patients reflecting those patients that saw a particular ob/gyn for their most recent visit.
  • Panel Member Years: A measurement of a physician’s Panel Members, adjusted for monthly changes in eligibility status.
  • Active Patient Base: The number of patients on a physician’s GYN Load at the beginning of a reporting period and seen in the previous 12 months, plus any new patients seen during the reporting period.
Available OGM Metrics
Quality
  • NOB & Postpartum Rates (HEDIS)
  • Mammography Rates (HEDIS)
  • Diagnosis-Based Outcomes
  • C-Section Rates
Completeness of Care

  • Oncology Referrals w/Non-Cancer Dx
  • Perinatology Referral Rate
  • Surgical Switches
Patient Satisfaction
  • Point of Contact Patient Surveys
  • Patient Switch Rates
Utilization
  • Age-Adjusted Surgery Rates
  • Ultrasound Rates (OB & Gyn)
Financial
  • Average Cost per Patient
  • Average Cost per Diagnosis
  • Average Cost per Procedure

Click here to see a sample OGM Provider Profile.

Points are assigned to each metric using either standard deviations or percentile ranking.

OGM delivers the profiles to the customer’s desktop in a “point and click” format. Network participants are arranged according to their performance on key metrics in both graphic and ranking format, with clear identification of outliers.

The intent of the OGM profiling program is to direct fee increases into the pay for performance program. Over time the program will generate considerable interest from the provider network.

OUR APPROACH
profiles
pay-for-performance
blended payments
consulting

CUSTOMERS
providers
health plans

about

management
contact