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• « Provider Incentives

State Medicaid programs have significant experience implementing pay-for-performance (P4P) initiatives -- about 30 states report that they are currently operating P4P programs. However, the vast majority of programs are designed for Medicaid health plans, with fewer examples at the individual provider level.  As many states anticipate adding P4P programs at the individual provider level, important considerations for states include determining how to select appropriate measures, attribute patients to physicians, and measure and report performance at the individual provider level.

Through this 90-minute webinar, states, health plans, and providers learned how Medicaid programs can influence quality at the point of care through provider-level P4P strategies. Participants learned about CHCS' Pay-for-Performance Purchasing Institute, which supported seven state Medicaid agencies in designing and testing financial and non-financial incentives; selecting performance measures; and engaging provider participation. Medicaid representatives from Massachusetts and Idaho shared lessons in developing provider-level P4P programs and Jean Moody-Williams from the CMS outlined important program design parameters.

The Presenters 

 Overview of the Pay-for-Performance Purchasing Institute

Nikki Highsmith, Senior Vice President, Center for Health Care Strategies
Dianne Hasselman, Associate Vice President, Center for Health Care Strategies 

 Massachusetts: Designing a Provider-Level P4P Program to Increase Medical Home Access

David Tringali, Associate Director for Quality and Planning, MassHealth Office of Clinical Affairs

  Idaho: Improving Diabetes Care Management through Physician-Level P4P 

Donald G. Norris, MD, Medicaid Medical Director, Idaho Department of Health and Welfare 

 CMS: Guidance on P4P Programs at the Provider Level 

Jean Moody-Williams, Director, Quality, Evaluation and Health Outcomes, Centers for Medicare and Medicaid Services