DPW Budget Update - Improving Health Outcomes through Performance Based Incentives
Pennsylvania’s Medical Assistance (MA) program focuses on managing individual’s physical health to improve well being and control costs. Depending upon where an individual lives, they will receive care either by:
- HealthChoices - Where an individual’s physical health needs is coordinated by one of the managed care plans contracted by DPW.
- ACCESS Plus – A fee for service model, that includes programs to assist people manage chronic disease and other case management services, that cover the 42 counties not in the HealthChoices program.
To learn where the AccesPlus and HealthChoices program operate in Pennsylvania, please go to this link.
Health Choices Program Use of Pay for Performance
The Health Choices managed care program, which serves over 60% of MA clients, designates part of the payment on nationally recognized quality measures. The result of moving towards pay for performance has improved quality of care including:
- Statistically significant improvements for 8 health measures between the baseline and 2008
- Improvements in the percentage of children age 2 who were screened for lead poisoning
- Continuous increases in the percentage of women ages 42 to 69 who received a mammogram
- The number of adolescents visiting their primary care physicians has increased in the past three years
ACCESS Plus uses Incentives to Improve Quality Care
ACCESS Plus – the fee for service program in MA which serves almost 40% of the MA population - also includes provider incentives to improve health outcomes. Examples of improvements include:
- Increase in children seeing their dentist annually, which help prevent future health problems
- Improving the use of medications for individuals with asthma, allowing them to better control their condition.
The mission of the Department of Public Welfare (DPW) is to protect and serve Pennsylvania’s most vulnerable citizens, to promote, improve and sustain the quality of family life, and to break the cycle of dependency, while managing our resources effectively and promoting respect for employees. The focus of DPW’s Budget is sustainability—preserving services for those who need them, quality and results—ensuring services improve the lives of those who receive them, and accountability— ensuring efficient use of tax dollars. For more information about the DPW budget visit www.dpw.state.pa.us.