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Trend: Medicaid programs offer P4P incentives

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Centers for Medicare and Medicaid Services (CMS)
medical groups
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pay-for-performance
health information technology
medicaid programs
Commonwealth Fund

A new survey by the Commonwealth Fund has concluded that more than half of U.S. states have begun rewarding doctors for delivering quality care to Medicaid patients. What's more, almost 85 percent of Medicaid programs plan to have pay-for-performance programs in place within five years, many of which rely on improved use of health information technology, researchers said. The study suggests that states are moving much more quickly than Medicare administrators, analysts say. CMS is offering doctors a chance to earn pay-for-performance bonuses under Medicare if they track quality-promoting services, but the program isn't required. However, the Institute of Medicine has recommended that Medicare implement a pay-for-performance system which cuts payments, then pays out some of the balance in rewards for consistently using health promotion measures. While medical groups have objected to the IOM proposal, which of course hits providers where they live, CMS continues to signal that it will continue move toward pay-for-performance reimbursement in the near future. However, it's not clear how aggressive CMS will be in rolling out these programs.

To get more background on this trend:
- read this article from the Associated Press
-
read the Commonwealth Fund report (.pdf)

Related Articles:
CMS extends pay-for-performance program. Report
Positive results for Medicare P4P pilot. Report
Exclusive: How to make P4P work. Interview
HMO pay-for-performance plans common. Report

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