miércoles, 4 de mayo de 2016

Medicaid Pay for Performance Programs and Childhood Immunization Status - American Journal of Preventive Medicine

Medicaid Pay for Performance Programs and Childhood Immunization Status - American Journal of Preventive Medicine

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Study Examines Medicaid Payment Programs’ Effect on Children’s Immunization Rates

A recent study found that children 19 to 23 months old who were enrolled in Medicaid pay-for-performance programs were 4 percent more likely to complete a recommended vaccination series.However, after analyzing a slightly broader age category—children 19 to 35 months old—the researchers found no overall effect on completion of a recommended vaccination series. These programs, also known as Value-Based Purchasing, reward physicians, hospitals and other health care providers for meeting certain performance measures for quality and efficiency. These programs are increasingly being used by state Medicaid programs to encourage high-quality care, but research on how the programs affect outcomes, such as childhood immunization rates, is scarce. More research is needed to fully understand the potential role of payments on improving vaccination rates, the authors stated. “Medicaid Pay for Performance Programs and Childhood Immunization Status” was supported in part by AHRQ and published online April 18 in the American Journal of Preventive Medicine. Read the full article.

Introduction

Although pay for performance (P4P) programs are being increasingly used by state Medicaid programs to provide incentives for managed care plans to provide high-quality care, no national study has examined the effects of these plans on commonly targeted outcomes such as childhood immunization rates.

Methods

Information from the 1999–2011 National Immunization Survey combined with information on state Medicaid P4P programs from the Centers for Medicare and Medicaid Services was used to study the effect of Medicaid P4P programs on the immunization status of children aged 19–35 months. Difference-in-difference-in-difference models were used to study whether adoption of Medicaid P4P programs was associated with higher immunization rates among Medicaid-eligible children relative to non–Medicaid eligible children within states that adopted Medicaid P4P programs compared with states that did not. Linear probability models were used in all estimations, and models controlled for demographic factors.

Results

The study found no overall effect of Medicaid P4P on the chance that children aged 19–35 months had completed the 4:3:1:3:3:1 vaccination series. However, there was a 4 percentage point increase in the chance that a child 19–23 months had completed the series.

Conclusions

This study provides some evidence that Medicaid P4P programs may be helpful in improving childhood vaccination rates. Further study of the effects on other targeted outcomes as well as the effects of different P4P program designs may increase understanding of the potential role of these programs in improving the quality of health care.

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