3M Health Information Systems
Thinking about clinical outcomes in Medicaid
Published in The Journal of Ambulatory Care Management
by Quinn, Kevin MA; Weimar, Dawn RN; Gray, Jeffrey RN; Davies, Bud MSc
As Medicaid expands in scope and influence, it is evolving toward being a “purchaser” of quality health care. This commentary discusses measurement and incentivization of clinical outcomes in Medicaid. Advantages and disadvantages of outcome versus process measures are discussed. Distinctions are drawn between the roles of Medicare and Medicaid, including the implications of the growth in Medicaid managed care. Medicaid‘s influence is particularly notable for obstetric, pediatric, newborn, and long-term care. We provide data on 3 Medicaid outcomes: potentially preventable hospital admissions, readmissions, and complications. The commentary concludes with suggestions for choosing and implementing outcome-oriented value-based purchasing initiatives in Medicaid.
Publication Date: 2016
Source: Quinn K, Weimar D, Gray J, Davies B. Thinking about clinical outcomes in Medicaid. The Journal of Ambulatory Care Management. 2016;39(2).