Survey Assesses States' Emphasis on Value-Based Health Care in Medicaid Managed Care Programs

In 2002, a research team surveyed state Medicaid officials on state efforts to measure and improve the quality of care delivered to beneficiaries in Medicaid managed care programs.

Specifically, the team sought to assess the states' use of value-based health care purchasing—the term for a broad array of efforts aimed at taking quality as well as cost into account when procuring health care services.

The team, led by Arnold M. Epstein, MD, MA, a professor at the Harvard University School of Public Health, compared the 2002 survey data with data from two similar surveys conducted in 1996 and 1999.

Key Findings

  • In 2004, the team reported its findings in two articles in Health Affairs. One article focused on state oversight of health maintenance organizations (HMOs), the other on primary care case management programs in Medicaid.

    • The 2002 survey found a "modest" increase in the percentage of state Medicaid managed care programs collecting performance data from health plans on patient satisfaction, patient access to care and the quality of care.
    • More Medicaid agencies were feeding health plan performance data back to the health plans, but the states still "rarely" provided the information directly to Medicaid beneficiaries.
    • There was an increase in the number of Medicaid agencies reporting that at least one health plan had documented improvement in at least one performance measure.
    • State Medicaid agencies were more likely to collect performance data from HMOs than from primary care case management programs—programs under which a Medicaid agency contracts directly with physicians to provide patient care.