Making pay-for-performance work in Medicaid.
Findings from a Medicaid pay-for-performance (P4P) demonstration suggest that "money talks" only sometimes, when supportive program elements give it voice. In this paper we examine five Medicaid-focused health plans that implemented new financial incentives for physicians to improve the timeliness of well-baby care. By contrasting the experiences of plans with better and worse outcome trends, we identify key program features--including strong communication with providers and placing enough dollars at stake to compensate providers for the effort required to obtain them--taking into account the starting point. The findings also highlight barriers to improvement that future Medicaid P4P efforts should consider.
Felt-Lisk
Suzanne
S
Mathematica Policy Research, Washington, DC, USA. SFelt-Lisk@mathematica-mpr.com
Gimm
Gilbert
G
Peterson
Stephanie
S
D002140:California; D002662:Child Health Services / Q000191:economics / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008484:Medicaid / Q000191:economics / Q000592:standards*; D010816:Physician Incentive Plans; D011314:Preventive Health Services / Q000191:economics / Q000592:standards*; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000191:economics*; D012052:Reimbursement, Incentive