Beginning in 2008, IBM, Wachovia, Novant-Presbyterian Healthcare, Belk and Duke Energy will reward physicians who provide quality care based on national standards. The five Charlotte, N.C. area companies have partnered with the Charlotte Health Care Collaborative in an effort to improve quality care for their workers.

The Charlotte program focuses on diabetes, cardiac care and physician-office care, which measures best office practices, including disease databases and electronic patient information. Organizers hope to add back/spine and oncology programs in upcoming years.

Companies like Verizon, General Electric, and Raytheon also have successfully implemented such pay-for-performance programs. If all goes expected, payouts will begin on Jan. 1, 2008.

The program guidelines are based on those recommended by Bridges to Excellence, a nationally recognized group that supports financial reward programs for doctors who meet certain standards of care.

The Bridges program recognizes evidence-based standards established by the National Committee on Quality Assurance, a nonprofit dedicated to improving health care quality.

Doctors who are NCQA certified have implemented best practices for at least a year before being admitted into the program.

"We wanted to pick up quality at the front end of the diagnosis to reduce emergency room costs on the back end," says Ches Gwinn, Health Care Collaborative project manager with Aon consulting.

Physicians can achieve recognition in three areas to be eligible for rewards, based primarily on treating diabetes, heart disease/stroke, back/spine problems and cancer.

Average rewards vary between $80 and $120 per patient, which can accumulate to a few thousand dollars or upwards of $50,000 per year.

"Providers and employers don't know why [the other one is] doing the things they do…They don't know how they can be of help to one another. [We're] working together to better understand the problem and what we can bring to the table," says Gwinn.