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papers

Achieving cost control, care coordination, and quality improvement in the Medicaid program

Published: January 1, 2010
Category: Papers
Author: Quinn K
Country: United States
Language: null
Type: Care Management
Setting: Hospital

J Ambul Care Manage 33:38-49; discussion 69-70.

ACS Government Healthcare Solutions, Helena, MT, USA

As Medicaid spending rises quickly, controlling cost while coordinating care and improving quality is paramount. Payment method reforms should reward providers that deliver beneficial care but not care of marginal value. This article draws lessons from previous payment reforms and analyzes the potential benefits for Medicaid of 7 specific proposals. The most promising are paying for quality (especially rewarding hospitals that reduce rates of potentially preventable complications and readmissions) and moving away from fee-for-service payment for “medical home” providers. To achieve reform, the article recommends a process characterized by persistence, attention to outliers, consultation, and timing.

Comment: Achieving cost control, care coordination, and quality improvement through incremental payment system reform.2010

PMID: 20026997

Care Coordination,Cost Burden Evaluation,Payment,United States,Targeted Program,Quality Assurance,Health Care/economics

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