Louisiana Kicks Off P4P Medicaid Program

Even as Louisiana struggles to rebuild its shattered healthcare infrastructure from Hurricanes Katrina and Rita, the state has kicked off one of the first Medicaid pay-for-performance programs in the nation.

The first checks went out in February to physician offices that both participate in the CommunityCARE primary care program for Louisiana Medicaid enrollees and report data to the Louisiana Immunization Network for Kids Statewide (LINKS) online immunization registry.

Although the LINKS has been around since 2001, the pay-for-performance aspect began last July with the start of the current fiscal year. After several months of data collection and approval from the federal Centers for Medicare and Medicaid Services, the incentive payments are new.

“This is the first time that physicians are actually seeing the monetary benefits from this program,” according to Roxane Townsend, deputy secretary of the Louisiana Department of Health and Hospitals. “For Louisiana, this is our first foray into pay-for-performance in the Medicaid program,” adds Townsend.

“It actually is data created in the physician office by the physician practice that identifies what their rate is on childhood immunizations,” says Townsend, who was Medicaid medical director in the department when data collection started.

Befitting a tight budget that is common in any state Medicaid program, the financial rewards are small. Any CommunityCARE practitioner that reports data to the LINKS registry will receive an extra payment of 25 cents per Medicaid enrollee under 21-years-old, each month.

“We will increase it further if you meet the benchmark of having your rate greater than the state average, and if you beat the national average, then we will increase you up to a dollar per member per month as an incentive,” Townsend says.

The program — with effective backups — proved its worth to public health agencies inside and outside Louisiana in the chaotic aftermath of Hurricane Katrina, which hit the Gulf Coast on Aug. 29, 2005. “Because there was a fail-over system for LINKS, it was able to be accessed the entire time during the storm. It was accessed from all 50 states and several foreign countries,” Townsend says.

She reports that LINKS saved $6.3 million in unnecessary re-immunizations because data were available to health and school officials that took in Katrina evacuees. With so many New Orleans residents fleeing to the Houston area, Harris County, Texas, alone saved $1.5 million due to LINKS, according to Townsend.

Meanwhile, the Louisiana Department of Health and Hospitals announced Friday that it has received a $15 million federal grant to help attract primary care physicians and other health professionals to the New Orleans area. Incentives may include up to $10,000 per person for continuing education in health-IT.

The state will accept applications at http://www.pcrh.dhh.louisiana.gov/ beginning March 30.

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