Journal Article

Moving toward paying for outcomes in Medicaid

With Kevin Quinn, MA, EMT-P, Norbert Goldfield, MD

Published by The Journal of Ambulatory Care Management, April/June 2018, 
by Billy Millwee MHA; Kevin Quinn MA, EMT-P; Norbert Goldfield, MD.

Medicaid can improve beneficiary health and help sustain its own future by embracing payment for outcomes. Good precedents exist from states such as Florida, Maryland, Minnesota, New York, Ohio, Pennsylvania, and Texas. Medicaid outcome measures include preventable admissions, readmissions, emergency department visits, and inpatient complications; early elective deliveries; infant and child mortality; patient-reported outcomes, satisfaction, and confidence; and reduction in low-value care. Criteria to prioritize initiatives include potential savings, availability of established models, impact on health status, and Medicaid’s ability to effect change. We offer five principles for success, emphasizing clinically credible initiatives that generate actionable information for clinicians.

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Source: Millwee B, Quinn K, Goldfield N. Moving toward paying for outcomes in Medicaid. The Journal of Ambulatory Care Management. 2018;41(2):88-94.