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Majority of State Medicaid Programs Plan 'Pay-for-Performance' Standards

Nationwide survey finds focus is on improving quality of U.S. care

THURSDAY, April 12, 2007 (HealthDay News) -- Almost 85 percent of states plan to have pay-for-performance programs for health-care providers within five years, says a U.S. study that also found that most current programs focus on women's, children's and adolescents' health issues.

The nationwide survey of state Medicaid programs was released Thursday by the Commonwealth Fund, a private organization working toward a high-performance health system in the United States.

"Medicaid is a major source of funding of health care in every state and, therefore, has a significant influence on the health care system," study co-author Thomas Hartman said in a prepared statement. "But each state operates its program independently of the others. We thought it would be helpful to provide a detailed snapshot of what is taking place around the nation so that state officials have solid information on which to base decisions about pay-for-performance."

Hartman is vice president for health care quality improvement at IPRO, a not-for-profit quality evaluation and improvement organization.

Hartman and his colleagues identified several trends:

  • Nine Medicaid programs -- Arizona, Kansas, Maine, Minnesota, New Hampshire, New York, Oregon, Vermont, and Washington -- are joining in statewide and regional pay-for-performance and quality improvement efforts, and a number of other state Medicaid programs are considering taking part in such collaborations.
  • A number of state Medicaid pay-for-performance programs -- Alabama, Alaska, Arizona, Massachusetts, Minnesota, New York, Pennsylvania, and Utah -- focus on health information technology by offering incentives to health providers to adopt electronic health records and electronic prescribing.
  • Seventy percent of existing Medicaid pay-for-performance programs operate in managed care or primary care case management environments, with a focus on preventive health services and on children's, adolescents' and women's health issues.
  • The majority of state Medicaid directors said their pay-for-performance priority is on improving quality of care, not on reducing cost.

More information

The U.S. Agency for Healthcare Research and Quality offers patients a guide to health care quality.

SOURCE: Commonwealth Fund, news release, April 12, 2007
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