Report shows hospitals support P4P program

Almost all hospitals support the Centers for Medicare & Medicaid Services (CMS) in moving forward with a pay-for-performance program over the next few years, but selecting the right measures will be a critical element of future success, according to a new report by Mathematica Policy Research.

The findings are based on a 2005 survey of hospital executives that Mathematica conducted for CMS, which explored hospitals' views on a future CMS pay-for-performance initiative and the quality measures it should include.

Most hospitals participating in the Hospital Quality Alliance supported using that program's original 10 measures or a slightly expanded set of measures, while most hospitals participating in the CMS/Premier Hospital Quality Incentive Demonstration favored using or expanding that program's 35 measures.

"In choosing measures, CMS will need to strike a balance between including a large number of measures to estimate hospital quality accurately in important clinical areas, and overwhelming hospitals with new measures they have not been reporting," said lead author Suzanne Felt-Lisk.


AHIP plan would expand SCIP, Medicaid coverage

A plan recently announced by America's Health Insurance Plans (AHIP) would expand the State Children's Health Insurance Program (SCHIP) to all uninsured children from families with incomes less than 200% of the federal poverty level and Medicaid to all uninsured adults with incomes less than 100% of the FPL.

Under the proposal, all children would have access to health insurance within three years, and 95% of adults would have access within 10 years, at an estimated cost to the federal government of $300 billion, according to AHIP.

The plan also would establish a "universal health account" that allows individuals to purchase any type of health coverage and pay for qualified medical expenses with pre-tax dollars. In addition, it provides for a tax credit of up to $500 for low-income families that secure health insurance for their children, and a $50 billion federal grant to help states expand access to coverage.