Pennsylvania’s Medicaid program has announced plans to launch a new hospital quality incentive program that will focus on measuring preventable hospital admissions and will reward hospitals that improve their performance.
The program, part of a larger effort by the state to move away from volume-driven Medicaid payments and toward a greater focus on value and population health, will measure and reward incremental improvement in reducing preventable admissions and achieving the 25th or 50th percentile benchmark of a state-wide preventable event rate. Hospitals that meet their objectives will qualify for bonus payments from the state funded by proceeds from Pennsylvania’s state-wide hospital assessment.
HealthChoices, Pennsylvania’s Medicaid managed care program, seeks to purchase 7.5 percent of Medicaid services through value-based purchasing arrangements in calendar year 2017, 15 percent in 2018, and 30 percent in 2019. The Hospital Quality Incentive Program seeks to facilitate achieving these goals.
The Pennsylvania Department of Human Services has posted on its web site an explanation of the new program, a presentation on the program, and an FAQ. Find them here.