Friday, January 11, 2013
In the last couple of months I’ve written about the importance of the national Title IV-E demonstration projects that were awarded to states (see A Child Welfare Funding Change – For The Better all members). All the national Title IV-E demonstration projects are geared to reduce costs by significantly reducing congregate care, and almost all participating states are designing their projects to deliver outcome oriented and evidenced based programs.
Michigan is one of the states selected for the demonstration project (see Michigan DHS Receives Federal Title IV-E Waiver To Launch Child Welfare Preventive Services Pilot Program ) – and their model is a case study in the move toward demanding documentation of performance. To give a quick background on the project, the Michigan Department of Human Services (DHS) is planning to launch a three-county child welfare preventive services pilot program for children up to five-years old. Up to 100 families can be served each year at each of the demonstration sites, for a total of 300 families each year. And, families referred to the project will be able to receive services for at least 15 months. What is also very interesting, is that the Michigan DHS will consider multiple strategies for the performance-based contracts to include an hourly unit rate for waiver interventions and bonuses.
In one of the proposed reimbursement strategies under consideration, provider organizations would be paid 75% of their billable costs with the remainder withheld as bonuses for meeting specific performance expectations. The contractor would be eligible for half of the amount withheld if after 12 months the family has avoided confirmed maltreatment or entry into foster care. The contractor would be eligible for the remaining funds if after 15 months the family has still avoided confirmed maltreatment and the children exhibit increased well-being.
We are seeing more payers moving to P4P strategies like this. The message is clear – provider organizations must achieve the outcomes that they say they can deliver. This brings up a good exercise for your management team. What are the outcomes that your services claim to deliver? How often do you achieve those outcomes? And, could you survive on reimbursement that only paid for that performance?
Senior Associate, OPEN MINDS
For another free resource, see: Treating The Whole Child all members all members
This is free for the next sixty days to all registered OPEN MINDS Circle members.