P4P: Money Talks–But Only Sometimes
June 26th, 2007
by
Chris Fleming
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A new study [2 weeks free access] in Health Affairs today shows that pay-for-performance (P4P) can work in a Medicaid managed care setting, but only if plans place enough dollars at stake and communicate well with providers. Suzanne Felt-Lisk and colleagues from Mathematica Policy Research evaluated a P4P demonstration of five Medicaid managed care plans in California and found mixed results.
These findings “underscore again that effective communication with physicians is essential for the success of P4P programs and that policymakers need to build enough resources and time into the implementation process to accomplish this,” notes University of Minnesota professor Jon Christianson in an accompanying Perspective [2 weeks free access].
The study, supported by the California HealthCare Foundation (CHCF), looked at a P4P demonstration aimed at improving the timeliness of well-baby care. Felt-Lisk and her coauthors also concluded that “the results also highlight the need for P4P programs to consider the barriers to practice improvement faced by providers who serve large numbers of low-income patients.”
Other states may want to take note of California’s experience. Christianson adds: “Because they were able to compare the experiences of different P4P programs that use the same performance measure for similar populations of patients, Felt-Lisk and colleagues’ study generates findings that are instructive to policymakers.”
P4P mixed results. This Medicaid study is one of several out recently that highlight the mixed results of P4P strategies. HealthBlawg reported earlier this month on a new JAMA study on Medicare’s cardiac care P4P program that “shows no significant improvement in care associated with P4P ‘carrots.’” KevinMD also blogs on the JAMA study, citing the need for “bigger carrots.” And in April, Health Affairs Blog reported on a paper citing concerns that P4P may actually decrease quality for minority and low-income patients.
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