Making Pay-For-Performance Work In Medicaid

Felt-Lisk, Suzanne; Gimm, Gilbert; Peterson, Stephanie
July 2007
Health Affairs;Jul2007 Supplement, Vol. 26 Issue 4, pw516
Academic Journal
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.


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