Quality Incentive Program improves health care for struggling New Yorkers

Healthfirst President and CEO Pat Wang has dedicated her career to championing the healthcare needs of vulnerable New Yorkers. In 1993, Pat helped create Healthfirst based on a pioneering value-based model that aligns payments for care delivery to the quality of care provided. In the following Op-Ed published in the Times Union Media Group newspaper, she discusses how the proposed elimination of QIP funding could affect healthcare in New York.

Health care reform is built on three pillars: coverage, affordability and quality. Any one of these pursuits is useless without the others. What good is coverage if the options are unaffordable? What good is affordability if the coverage is of poor quality?

One of the best investments the Empire State has made to improve quality and outcomes for millions of low-income New Yorkers is the Medicaid Quality Incentive Program (QIP). New York administers its Medicaid program through contracted managed-care organizations and has pushed them to achieve better-quality results through bonus payments to the entities that provide the best care to their members. Managed-care organizations are measured on many of the key markers of health disparities experienced by low-income communities and people of color, including timely pre- and postnatal care for pregnancy, timely screenings for breast and colorectal cancers, and the proper management of asthma, to name a few.?

Healthfirst uses its QIP earnings to fund bonus payments to its highest-performing provider partners.?Clinicians appreciate being rewarded for quality, making this a win-win, repeatable cycle that benefits everyone.

Many of the providers who receive quality awards are safety-net providers who would otherwise be unable to fund quality improvement initiatives. Providers have used their QIP-funded bonuses to hire additional staff to make phone calls to schedule patients for breast cancer screenings, purchase technology to remind parents about pediatric appointments for their children, and staff weekend and evening hours to expand access for working families.?

Unfortunately, Gov. Kathy Hochul’s budget proposal eliminates the QIP entirely. The state budget office projects that eliminating the program would save around $52 million, but this is a penny-wise, pound-foolish approach. The QIP more than pays for itself by creating cascading incentives – from the state to Medicaid plans to their providers – to improve health outcomes in the most vulnerable populations. New York should not dumb down its Medicaid program by zeroing out its commitment to quality.

We are grateful to the Senate, which acknowledged the value of the QIP in their budget proposal by fully restoring?the QIP?and permanently establishing the program into law, protecting it from elimination in future budgets.?

Healthfirst serves more than 1.2 million Medicaid members, or 23 percent of statewide Medicaid beneficiaries, who are low-income and disadvantaged. We know from experience that the QIP is essential to addressing health disparities. I urge the Legislature and the governor to maintain its historical commitment to the “quality” pillar of the health care equation and to adopt the Senate’s budget position to fully fund the Quality Incentive Program.