With pay-for-performance (P4P) programs becoming common among private health plans, more states are considering ways to integrate both financial and non-financial incentives into their Medicaid programs. States are taking a number of different approaches toward Medicaid P4P—overcoming significant challenges along the way. This profile reviews some of those challenges, highlights a few state strategies, and describes new trends in the use of quality incentives.
Louisiana submitted a concept paper to CMS outlining a proposed redesign of New Orleans' health care system that would address the state's high uninsured rate, improve quality of care, and create a more stable infrastructure in the aftermath of Hurricane Katrina.
Maine's Blue Ribbon Commission on Dirigo Health made recommendations to the governor about how the program should be funded, including: increasing the tax on tobacco products, establishing a snack tax and a tax on soft drinks and syrups, and creating a beer and wine tax. In addition, they endorsed the continued capture and redirection of bad debt and charity care funding.
The New York Commission on Health Care Facilities in the 21st Century, which is charged with "rightsizing institutions," released a report recommending the closure of nine hospitals, the merger or conversion of several other facilities, and the elimination of others if they ultimately fail to merge.
Rhode Island's Legislature passed a bill requiring health plans that offer small group and individual market products to develop a "wellness health benefit plan" for employers with up to 50 employees as well as individuals.
The November 7 election brought many changes at the national and state levels. In mid-January, a bipartisan group of lawmakers unveiled legislation that would provide federal funding for state initiatives to provide health care coverage to the uninsured. And number of states elected governors who ran on platforms in which health care was the number-one priority.