Pay for Performance in Medicaid: Evidence from Three Natural Experiments

Health Services Research

Volumn 51, Issue 4, 2016, Pages 1444-1466

  Rosenthal, Meredith B ^a   Landrum, Mary Beth ^b   Robbins, Jacob A ^c   Schneider, Eric C ^d  

^a HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

^c BROWN UNIVERSITY   (United States)

^d The Commonwealth Fund ^*  (United States)

Author keywords

Medicaid; Pay for performance; shared savings; value based purchasing in provider relationships

Indexed keywords

ACCOUNTABLE CARE ORGANIZATION; ALABAMA; DOCTOR PATIENT RELATION; EMERGENCY WARD; FLORIDA; HOSPITAL ADMISSION; HUMAN; MEDICAID; MINNESOTA; PENNSYLVANIA; PROPENSITY SCORE; PURCHASING; STUDY DESIGN; TOTAL QUALITY MANAGEMENT; WISCONSIN;

EID: 84978285334     PISSN: 00179124     EISSN: 14756773     Source Type: Journal    
DOI: 10.1111/1475-6773.12426     Document Type: Article

References (24)

1. Agency for Healthcare Research and Quality (AHRQ). 2012. Prevention Quality Indicators. Rockville, MD: Agency for Research and Quality.
2. Billings, J. 2002. ACS Conditions. New York: NYU Wagner School of Public Service.
3. Borck, R., V. Cheh, and L. Lucy. 2011. Recent Patterns in Children's Medicaid Enrollment: A National View. Princeton, NJ: Mathematica Policy Research.
4. Chien, A., Z. Li, and M.B. Rosenthal. 2010. “Improving Timely Childhood Immunizations through Pay for Performance in Medicaid-Managed Care.” Health Services Research 45 (6): 1934–47.
5. D'Agostino, R. 1998. “Propensity Score Methods for Bias Reduction in the Comparison of a Treatment to a Nonrandomized Control Group.” Statistics in Medicine 17: 2265–81.
6. Dudley, R.A., A. Frolich, D.L. Robinowitz, J.A. Talavera, P. Broadhead, and H.S. Luft. 2004. Strategies to Support Quality-based Purchasing: A Review of the Evidence. Rockville, MD: Agency for Healthcare Research and Quality.
7. Falik, M., J. Needleman, B.L. Wells, and J. Korb. 2001. “Ambulatory Care Sensitive Hospitalizations and Emergency Visits: Experiences of Medicaid Patients Using Federally Qualified Health Centers.” Medical Care 39 (6): 551–61.
8. Federal Register. 2012. “Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule.” 74 FR. C. f. M. M. Services. Washington, DC. 44721: 44721 -45061.
9. Felt-Lisk, S., and F. Smieliauskas. 2006. Evaluation of the Local Initiative Rewarding Results Collaborative Demonstrations: Final Report. Washington, D.C.: Mathematic Policy Research.
10. Highsmith, N., and J. Rothstein. 2006. Rewarding Performance in Medicaid Managed Care. Hamilton, NJ: Center for Health Care Strategies.
11. Hillman, A.L., K. Ripley, N. Goldfarb, I. Nuamah, J. Weiner, and E. Lusk. 1998. “Physician Financial Incentives and Feedback: Failure to Increase Cancer Screening in Medicaid Managed Care.” American Journal of Public Health 88 (11): 1699–701.
12. Hillman, A., K. Ripley, N. Goldfarb, J. Weiner, I. Nuamah, and E. Lusk. 1999. “The Use of Physician Financial Incentives and Feedback to Improve Pediatric Preventive Care in Medicaid Managed Care.” American Journal of Public Health 104 (4): 931–5.
13. Iacus, Stefano.M., G. King, and G. Porro. 2009. “CEM: Software for Coarsened Exact Matching.” Journal of Statistical Software 30: 1–27.
14. Kaiser Commission on Medicaid and the Uninsured. 2013. Medicaid: A Primer. Washington, D.C.: Kaiser Family Foundation.
15. Karaca-Mandic, P., E. C. Norton, and B. Dowd. 2012. “Interaction Terms in Nonlinear Models.” Health Services Research 47(1pt1): 255–274.
16. Kuhmerker, K. 2007. Pay-for-Performance in State Medicaid Programs: A Survey of State Medicaid Directors and Programs. New York: T. C. Fund.
17. Merrill, A., and M. Rosenbach. 2006. “SCHIP and Medicaid: Working Together to Keep Low-Income Children Insured.” Final Report Submitted to the Centers for Medicare & Medicaid Services. Cambridge, MA: Mathematica Policy Research.
18. National Committee on Quality Assurance. 2012. HEDIS 2012 Measures. Washington, D.C.
19. Petersen, L., L. Woodward, T. Urech, C. Daw, and S. Sookanan. 2006. “Does Pay-for-Performance Improve the Quality of Health Care?” Annals of Internal Medicine 145 (4): 265–72.
20. Rau, J. (2012, October 1) “Medicare Begins Latest Pay-for-Performance Effort; Hospital Readmissions Among Program Targets.” Kaiser Health News.
21. Rosenbaum, P., and D. Rubin. 1984. “Reducing Bias in Observational Studies Using Subclassification on the Propensity Score.” Journal of American Statistical Association 97 (387): 516–24.
22. Rosenthal, M.B., and R. Frank. 2006. “What is the Empirical Basis for Paying for Quality in Health Care?” Medical Care Research and Review: MCRR 63 (2): 135–57.
23. Rubin, D. 1998. “Estimating Causal Effects from Large Data Sets Using Propensity Scores.” Annals of Internal Medicine 127 (8S): 757–63.
24. Scott, A., P. Sivey, D. Ait Ouakrim, L. Willenberg, L. Naccarella, J. Furler, and D. Young. 2011. “The Effect of Financial Incentives on the Quality of Health Care Provided by Primary Care Physicians.” Cochrane Database of Systematic Reviews (9): CD008451.