Treatment Provider Incentives

Treatment provider incentives are the most common type used in pay-for-performance systems. These incentives often reward providers for organizational or staff performance in meeting a particular target.

Examples include:

• National Committee for Quality Assurance’s Health Plan Employer Data and Information Set (HEDIS) measures
• Client attendance, engagement or length-of-stay measures
• Client satisfaction measures
• Core staff competency measures (e.g. two certified therapists) or the utilization of a specific instrument (e.g., nine question Patient Health Questionnaire)

The incentive and reward structure is then based on the measure (Bremer et al., 2008; McLellan et al., 2008; Pelonero & Johnson, 2007; Shen, 2003; Shepard et al., 2006).

Recently, the state of Oklahoma has shifted the focus of these treatment provider incentives to reward providers for their process improvement efforts, such as implementing and sustaining changes and establishing a business case for change.

Regardless of the type of provider incentive, it must be meaningful, achievable, and minimize provider data collection burdens.

References

• Bremer, R.W., Scholle, S.H., Keyser, D., Houtsinger, J.V.K. & Pincus, H.A. (2008). Pay for Performance in Behavioral Health. Psychiatric Services 59(12):1419-1429.
• McClellan, A.T., Kemp, J., Brooks, A., Carise, D. (2008). Improving public addiction treatment through contracting: The Delaware Experiment. Health Policy 87: 296-308.
• Pelonero, A.L. & Johnson, R.L. (2007). A Pay-for-Performance Program for Behavioral Health Care Providers. Psychiatric Services 58(4):442-444.
• Shen, Y. (2003). Selection Incentives in Performance-Based Contracting System. Health Services Research 38(2):535-552.
• Shephard, D.S., Calabro, J.A.B., Love, C.T., McKay, J.R. et al. (2006). Counselor Incentives to Improve Client Retention in an Outpatient Substance Abuse Aftercare Program. Administration and Policy in Mental Health and Mental Health Services Research 33(6):629-635.