SIP PERFORMANCE COMPENSATION PLAN (INCENTIVE) FOR SPECIALISTS 2023 - SUTTER INDEPENDENT PHYSICIANS Revised January 2023
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2023
SIP PERFORMANCE COMPENSATION PLAN (INCENTIVE)
FOR SPECIALISTS
Revised January 2023
SUTTER INDEPENDENT PHYSICIANS
Program Summary
Incentive Eligibility Requirement for All Physicians – Physician Meeting Attendance
Physician Member To be eligible for a performance compensation award for any half-year period, physicians must Meeting attendance AND
attend at least one member meeting every six months. All members are welcome to attend any of after-meeting survey is
Meetings required to receive credit
the meetings. and payment of $300.
Physician Meeting Patient Volume
Amount Paid
Item Description Attendance Factor Applied*
(Yearly – in two installments)
Required (YES/NO) (YES/NO)
Adult Specialists:
~$10K for ≥ 90 percent rating in definitely
“Would Recommend” linearly decreasing to
We can now survey ALL your $2K for 80 percent rating; maximum awards
patients so that every practice require 20 surveys (including “Would
should have enough responses to Recommend” responses) every 2 months.
Patient understand how they are doing and to
YES YES
Satisfaction participate in this portion of the SIP Pediatric Specialists other than
incentive. Each physician may receive neonatologists:
an award based upon the “Would ~$20K for ≥ 90 percent rating in definitely
Recommend” question. “Would Recommend” linearly decreasing to
$2K for 80 percent rating; maximum awards
require 20 surveys (including “Would
Recommend” responses) every 2 months.
1Program Summary
Physician Meeting Patient Volume
Amount Paid
Item Description Attendance Factor Applied*
(Yearly – in two installments)
Required (YES/NO) (YES/NO)
Since we began to include specialists
in measuring BP, our control of
hypertension has improved resulting in ~$10K for measuring and documenting BP on
better health for our patients – and a ≥ 95% of adult patients, decreasing linearly to
larger incentive pool for our $2K for 50%.^
physicians.
Cardiologists:
Accordingly, SIP is continuing to ~$5K for measuring and documenting BP on
provide awards for measuring BP at ≥ 95% of adult patients, decreasing linearly
E&M visits: ~$10K for measuring and to $1K for 50%.^
Quality documenting BP on ≥ 95% of adult ~$5K for having ≥ 90% patients with
Adult patients, decreasing linearly to $2K Cardiovascular Disease receiving a medium
YES YES
Specialists for 50%.^ to high dose statin, decreasing linearly to
$2.5K for 80%.***
Cardiologists: 50% of their quality
amount is based upon their patients OB/GYNs:
with Cardiovascular Disease receiving ~$10K for measuring and documenting BP
a medium to high dose statin. on ≥ 95% of adult patients, decreasing
linearly to $2K for 50%.^
OB/GYNs: A supplement is provided
PLUS $200 for every pregnant patient who
for providing vaccinations to pregnant
receives influenza and TdaP immunizations.
patients, regardless of who administers
the vaccinations (OB, PCP, or
pharmacy).
2Program Summary
Physician Meeting Patient Volume
Amount Paid
Item Description Attendance Factor Applied*
(Yearly – in two installments)
Required (YES/NO) (YES/NO)
Neonatologists:
Individual Award:
~$10K for having 75% of infantsProgram Summary
Physician Meeting Patient Volume
Amount Paid
Item Description Attendance Factor Applied*
(Yearly – in two installments)
Required (YES/NO) (YES/NO)
$300, 2x/yr for completing a SIP
wellness survey.
$600 total/yr for participating in a SIP
SIP also promotes physician wellness survey (maximum of $300 each,
collaboration and camaraderie by x2/yr)
paying for SIP physicians’ dinners at
Physician journal clubs, practice meetings, $300 total/yr for dinner meetings (maximum NO NO
Wellness and/or discussion meetings that of $50/each physician, x6/yr)
include wellness, up to $50 each, once
every 2 months. $300 total/yr for participating in a EMR
Optimization session
EMR Optimization sessions led 1:1’s
with our EMR Champion(s)
Service Physician Learning Events hosted by
$600 total/yr for each service excellence
Excellence the Service Excellence Team to assist learning event (maximum of $300 each, NO NO
Learning physicians with issues around patient x2/yr)
Events satisfaction, processes, etc.
SIP encourages innovation projects
that improve quality, patient
satisfaction, and/or physician wellness ~$6K (maximum of $3K each project,
Innovation x2/yr)
YES YES
– other great ideas are welcome also.
You can do one project every 6
months.
4Program Summary
Final Program Details
Physicians must meet minimum standards to receive a performance compensation payment:
1. Attend one physician meeting in each half year to receive an award for that period. $300/per meeting will be awarded to PCPs and Specialists
for each designated meeting attended. Meeting attendance AND completing the after-meeting survey are required for meeting credit.
2. Be a SIP member in good standing on the last day of the performance assessment period and, if not retired, at the time awards are issued.
Key Aspects
• Performance Compensation Program awards are not guaranteed and are dependent upon SIP’s financial performance
• All amounts are subject to change based upon the availability of funds
• One member meeting in each 6-month period is required to receive the incentive award for that period
Footnotes
* The Specialist patient volume factor is 1.0 for unique SIP patient volumes ≥ 65, decreasing arithmetically to 0.5 for a unique SIP patient
volume of 6.
** The actual cost of a monthly SCC contract is calculated as average of the total cost for all qualifying physicians in a practice.
*** Documentation of a statin prescription is not sufficient. There must be dispensing data from a pharmacy. Minimum number of patients in the
denominator = 10. If fewer than 10 patients, the BP incentive for other adult specialists is used.
**** Minimum number of patients in the denominator = 5. If fewer than 5 patients, the BP incentive for other adult specialists is used.
^ Documentation requires SCC or using CPT II Codes. Minimum of 4 encounters in the denominator.
^^ 2022 MY measurement year period is February – June for Mid-Year, and then July – December Year-End incentive periods
5Program Summary
Information on measuring and recording BP follows:
Getting Quality Credit for the SIP Performance Compensation Plan for measuring in-person BP
(telehealth visits should be excluded by adding G9745 to the claim):
Those who are not using SCC must submit CPT II codes (and enter the BP in their chart)
• What are CPT II Codes? CPT Category II codes are tracking codes which facilitate data collection for the purposes of performance
measurement.
• How do I use CPT II Codes? CPT II codes are billed in the procedure code field just as CPT Category I codes are billed. CPT II codes
describe clinical components usually included in evaluation and management or clinical services. To ensure proper acceptance of the billed
claim make sure to bill CPT II codes with a $0.01 billable charge amount.
CPT Category II Code Summary List
Quality Measure CPT II Code and Description
Systolic Code Systolic Level Diastolic Code Diastolic Level
Controlling Blood 3074F < 130 3078F < 80
Pressure 3075F 130 – 139 3079F 80 – 89
3077F ≥ 140 3080F ≥ 90
6Program Summary
Specialists who are using SCC just need to have their MA enter the BP in the vital signs section:
Your office (SCC or not) needs to have a standard policy to guide how to measure BP and what to do with an elevated BP reading. The suggested
SIP policy follows:
Resources for measuring BP in the office
Create a workflow:
1. Be certain that all of the physicians in the practice support BP measurement and will act upon high BP readings – and will support your MA’s
(see #7).
7Program Summary
2. Decide where and how the blood pressure will be measured in your office.
a) This is usually in the exam room, but other consistently used locations, such as a chair by a hallway scale, can be employed.
3. Decide who will measure the BP. This is usually the MA who rooms the patient.
4. Decide what technique will be used to do the measurement:
a) Manual BP cuffs are fine
b) Automated cuffs offer the advantage of accuracy, speed, and reliability with less training
i. SIP can obtain a discount for you: $650-$850 depending on mounting. Contact Mary Kabia (kabiam2@sutterhealth.org) if you
are interested.
5. Be sure that your MA is trained on how to accurately measure BP. SIP can provide a simple brochure/wall chart. Contact Dani Lewis
(lewisdm@sutterhealth.org) if you want some for free!
a) Video for MA’s: https://www.youtube.com/watch?v=-LqKmrmaHsk
b) Key elements are to have the patient sit in a chair with feet on the floor, ideally for a few minutes before taking the pressure, support
the arm, and no talking by the patient or MA.
6. Record the BP in your chart, along with any action that was taken – see below. Have the MA place a red heart (or other reminder) on your
chart or the exam room door for any patient with an elevated BP to bring this to your attention.
7. Refer to the algorithm below for what to do with the results:
• If the BP is elevated (greater than 139/89), have the patient sit for 5 minutes and repeat.
• If the repeated SBP is 140-179 or the DBP is 90-109, request the patient to follow up with PCP within 2-4 weeks.
• If the repeated SBP is 180-209 or the DBP is 110-119, your office should call the PCP to request a same day appointment or for
recommendations for this patient. If unable to contact PCP, refer to Urgent Care.
• If the repeated SBP is greater than 209 or the DBP is greater than 119, consider this emergent and refer to the ED.
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