Quality-Related Provider and Member Incentives in Medicaid Managed Care Organizations
Over the last several years, states and Medicaid managed care organizations (MCOs) have undertaken a variety of initiatives that seek to reward quality in Medicaid managed care. States have provided financial and other incentives to Medicaid MCOs tied to various measures of quality, and MCOs have in turn developed quality incentives for the providers and members in their networks. The report offers seven broad lessons for MCOs and states that are considering quality-related incentive programs, based on our detailed review of the programs developed by five leading Medicaid health plans in three states: California, New York, and Rhode Island. The lessons focus on commitment of leadership, incentives lining up with goals, and the need for understanding physician attitudes, to name a few.
