Medicaid Pay-For-Performance (P4P) Programs and the Use of Preventive Health Care Services: A Preliminary Analysis of Immunization Status among Young Children*
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Medicaid Pay-For-Performance (P4P) Programs and the Use of Preventive Health Care Services: A Preliminary Analysis of Immunization Status among Young Children*

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  • English

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    • Alternative Title:
      Am J Prev Med
    • Description:
      Introduction: Although Pay-for-Performance (P4P) programs are being increasingly used by state Medicaid programs to provide incentives for managed care plans to provide high quality care, no national study has examined the effects of these plans on commonly targeted outcomes such as the use of particular preventive care services. Methods: We use information on state Medicaid P4P programs from the Centers for Medicare and Medicaid Services combined with information from the National Immunization Survey 1999–2011 to study the effect of Medicaid P4P programs on children’s immunization status. We use difference-in-difference models that compare the effect of P4P programs on children’s immunization status for children estimated to be Medicaid-eligible before and after introduction of a P4P program relative to the “pre-post” change for other children in the same group of states. We also estimate difference-in-difference-in-difference models that compare these changes to those for children in states that do not implement P4P. Results: We find that Medicaid P4P increases the probability that a Hispanic or non-Hispanic white child is up-to-date on several vaccinations. For example, we find that the chance that these children are up-to-date on the measures, mumps, and rubella series increased by about 2.7–2.9 percentage points. However, we do not find statistically significant effects on all vaccines, and no statistically significant effects for non-Hispanic black children. Conclusions: This study provides some evidence that Medicaid P4P programs may be helpful in improving childhood vaccination rates. Further study of the effects on other targeted outcomes as well as the effects of different P4P program designs may further increase our understanding of the potential role of these programs.
    • Source:
      Am J Prev Med. 50(5 Suppl 1):S51-S57
    • Pubmed ID:
      27102859
    • Pubmed Central ID:
      PMC7375194
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