Government

Pay-for-performance for Medicaid

NEWS IN BRIEF — Posted Aug. 8, 2005

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Although much of the Washington debate about pay-for-performance has revolved around Medicare, federal officials are working on plans to expand performance-based reimbursement in the Medicaid program.

The Centers for Medicare & Medicaid Services is studying programs that several states have launched to pay doctors based on their quality of care, said Terris King, deputy director at the CMS Office of Clinical Standards and Quality, at a recent event.

Federal officials hope other states will take up the lead once the agency shows how pay-for-performance can work to improve quality within the low-income health program, he said.

Medicare already is using a pilot program to experiment with reimbursing physicians based on how well they improve patient outcomes and save money for the federal government. Lawmakers are considering legislation that would expand the concept to include all Medicare doctors within several years.

The Medicare pilot program, unveiled earlier this year, encountered criticism because of its initial focus on cutting costs rather than improving care. Federal officials decided not to commit any additional resources to making the performance-based payments to doctors.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/08/08/gvbf0808.htm.

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