Pay for performance/incentives

Innovations

State Medicaid Program Adopts Multiple Policies to Significantly Increase Screening Rates and Enhance Access to Services for Young Children at Risk of Developmental Disabilities 06/10/13

The Oregon Health Authority (which oversees the State Medicaid program) initiated a series of policy changes to promote earlier detection, more effective referrals, and better coordination of care for pediatric patients with developmental delays, leading to a significant increase in screening rates and enhanced access to early intervention services.

Statewide Measurement and Reporting System Stimulates Quality Improvement in Targeted Clinical Areas, Becomes Standard for Local and National Pay-for-Performance Programs 04/23/13

A statewide measurement and reporting system serves as a single, comprehensive, credible source of information on provider performance, leading to significant improvements in performance over time and to adoption and use of the system by local and national payers and other organizations.

State–Federal Program Provides Capitated Payments to Plans Serving Those Eligible for Medicare and Medicaid, Leading to Better Access to Care and Less Hospital and Nursing Home Use 03/13/13

A combined State-Federal program pays health plans a capitated fee to provide and coordinate acute, primary, long-term care as well as social services to those eligible for Medicare and Medicaid, leading to enhanced access to care, fewer inpatient admissions and nursing home placements, and high levels of beneficiary and provider satisfaction.

Coordinated, Intensive Medical, Social, and Behavioral Health Services Improve Outcomes and Reduce Utilization for Frequent Emergency Department Users 03/04/13

Intensive, concurrent medical and behavioral health care, addiction services, and social service coordination improve patient outcomes and reduce health system use among patients who historically have been frequent users of emergency departments.

Health Plan's Multifaceted Strategy Involving Care Coordination, Disease Management and Physician Incentives Leads to Better Outcomes and Reduced Costs for Medicare Advantage Enrollees 03/03/13

HealthSpring's Partnership for Quality program offers bonuses to physician practices and onsite care coordination and disease management support, leading to significantly better outcomes and reduced costs for Medicare Advantage enrollees.

Plan-Supported Medical Home Model Helps Clinics Enhance Access, Improve Quality, and Reduce Admissions for Medicaid Managed Care Enrollees 03/03/13

A plan-supported medical home model used by clinics serving Medicaid managed care beneficiaries enhances access to care, improves quality, and reduces inpatient admissions.

Health Plan's Comprehensive Strategy Involving Physician Incentives and Targeted Recruitment Enhances Patient Access to Language-Concordant Physicians 03/02/13

A large medical group developed a comprehensive strategy to increase the number of physicians who speak languages other than English in order to improve access for patients with limited English proficiency.

Statewide, All-Payer Financial Incentives Significantly Reduce Hospital-Acquired Conditions in Maryland Hospitals 02/28/13

Financial incentives used by all Maryland public and private payers significantly reduce hospital-acquired conditions in hospitals throughout the state.

Statewide, All-Payer Financial Incentives Tied to Process, Patient Experience, and Outcomes Measures Lead to Better and Less Variable Hospital Performance 02/26/13

A statewide, all-payer initiative creates financial incentives tied to hospital performance on process, patient experience, and outcomes measures, leading to better and less variable performance.

Initiative Features Fixed Monthly Payments to Primary Care Clinics for Providing Depression Care Bundle, Allowing Many Patients to Achieve Good Outcomes 02/19/13

A collaborative initiative features standardized care elements and fixed per-patient payments for treatment of depression in the primary care setting, leading to high rates of remission and response to treatment and high levels of provider satisfaction.

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