Pay for Performance strategies for physicians – 8/26/05

Q:

Does your state have any "Pay for Performance" strategies that states may be employing with MDs who treat Medicaid Recipients and Ask, Advise and Refer to quit lines or local resources?

A:

1. Alabama: Alabama does not have a "pay for performance" program to encourage healthcare providers to implement the 5 As model.
    
2. Michigan: Michigan is currently discussing/researching this idea.
    
3. Oregon: Two of Oregon's health plans included "documentation of smoking status" and "advice to quit" in their quality bonus programs. Contracts set-aside funds that were paid after a chart audit showed how well physicians were meeting targets on a variety of measures. The amounts of money were small.
    
4. Washington: Washington has a pay for performance, fee for service reimbursement for physicians who counsel Medicaid pregnant patients. Please see the documents below for additional information:

• Smoking Cessation for Pregnant Women MAA memo pages
• DSHS MAA Benefit Referral Card
• P4P Report from Inland Northwest Business Council for Health – provides overview of several different pay for performance initiatives that have been introduced around the nation

5. West Virginia: West Virginia has had several planning meetings regarding potential programs to reimburse physicians for promoting cessation, especially for our large state Medicaid population. We do offer (through a funded
   intervention with our State Medical Association) a provider training
   program to incorporate cessation counseling into clinical practice. To
   date, however, we do not have in place a 'pay for performance'
   reimbursement program.
    
6. National Partners
   Center for Tobacco Cessation: Current Cessation Treatment Programs-see pg. 2

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