Pay for performance/incentives
A statewide, multipayer pilot program provides technical and financial support to physician practices interested in becoming patient-centered medical homes, leading to all participating practices being recognized as medical homes and to anecdotal reports of better access and higher quality.
As part of a statewide public-private initiative, the diverse Burlington (Vermont) health service area supports 18 patient-centered medical home practices via a multidisciplinary team, real-time electronic information, and financial incentives, leading to more appropriate care, better health outcomes and patient experiences, and lower utilization and costs.
A large health plan's multifaceted program promotes appropriate prescribing and monitoring of opioid therapy for patients with chronic pain not caused by cancer, leading to enhanced physician knowledge and confidence related to prescribing, greater use of care plans and drug screening, and fewer patients on high-dose therapy.
A Medicaid managed care plan offers a patient-specific pay-for-performance program tailored to the needs of both large and small practices serving vulnerable populations, leading to improvements in immunization rates and diabetes care.
A large insurer offers financial incentives and other support to provider-led quality improvement collaborations, leading to high levels of provider participation, higher quality, lower costs, and a positive return on investment.
A large insurer offers provider organizations 5-year contracts that feature accountability for costs and quality across the continuum of care, leading to broad participation, significant provider investments in delivery system redesign, a slowdown in spending growth, and higher quality.
A statewide program supports physician practices through multidisciplinary community-based health teams, preventive health expertise, easy access to needed information via electronic systems, and financial incentives, leading to lower utilization and growth in health care spending and enhanced provision of appropriate services.
A state mental health and addiction services agency implemented policies to promote integrated treatment for those with both mental health and substance use disorders, leading to enhanced access to high-quality services and positive patient outcomes.
A health plan–sponsored disease management program targeting African Americans combines home blood pressure monitoring with culturally competent education and counseling, leading to better self-monitoring and blood pressure control.
Pharmacists provide ongoing chronic care management support to employees and their physicians, leading to greater adherence to recommended care processes and self-management behaviors, lower costs, higher productivity, and a significant return on investment.