Pay for Performance in Medicaid Risk-based Managed Care
under a slate of multi-billion-dollar Medicaid managed care contracts, Ikaso worked to ensure that a state government was able to provide the best services and health outcomes in a program serving older adults, individuals with a disability, current and former foster children, and children receiving adoption assistance
The Challenge
Creating incentives for Medicaid plans that drive the best possible performance within broad-ranging and complex contracts.
The Outcome
A comprehensive slate of performance measures, addressing different areas of health outcomes measures with targeted incentive structures.
Values-Centered Approach
Our team relied on the value of collaboration when approaching this project. We worked with a broad range of stakeholders for input on the most important areas on which to focus performance incentives. This collaboration enabled us to find the best incentive mechanisms for each area.
Highlighted Results
We used stakeholder feedback to negotiate contracts that focused on the state’s operational and health outcome priorities. Our team developed a balanced “carrot and stick” approach that used tools like liquidated damages, capitation payment withholds, and available bonus funds, each aligned to specific areas of vendor performance and health outcomes achievement.
