Using Provider Payment Incentives to Reduce Health Disparities in Fairfax County
Len Nichols (L) and Kalahn Taylor-Clark (R)
October 24, 2014 – Len Nichols, PhD, Professor and Director of the Center for Health Policy Research and Ethics, and Kalahn Taylor-Clark, PhD, Assistant Professor in the Department of Health Administration and Policy and Senior Advisor to the Center for Health Policy Research and Ethics, were awarded a three-year grant for $488,000 from the Robert Wood Johnson Foundation titled, “Effects of Payment Incentives on Care Processes in a Network Serving Multi-Ethnic Uninsured Populations.”
Funding for this project grew out of a long standing partnership among the Center for Health Policy Research and Ethics, Fairfax County Health Department, and Molina Healthcare (Molina), a clinical contractor that provides health services to low-income families and individuals who do not have access to insurance of any kind, public or private. Fairfax County contracts with Molina to manage three health clinics within the Community Health Care Network (CHCN), which are located in areas that have a disproportionately high number of low-income and uninsured residents. “Molina, under Fairfax County’s arrangement, is a perfect partner for this work. [They have] health plans, medical clinics, and a health information management solution. No other organization of its kind performs all three essential functions,” says Dr. Nichols. Dr. Taylor-Clark adds, “Our goal for this project is to reduce health disparities that we see in this population by building on existing payment incentives and rewarding provider teams for better connecting patients to appropriate services in areas related to cholesterol-lowering drugs, cervical cancer screening, and smoking cessation counseling.”
The team hypothesizes that providing incentives to clinicians and their support staff will encourage them to deliver themselves or refer patients to clinical or social services that address these health issues that disproportionally impact this population. Examples of incentives include: encouraging more smoking cessation counseling and referrals for patients, increasing access and number of pap smears provided by clinicians, and increasing appropriate use of statins. Along with the project’s newest partners, Health Management Associates and research led by Catherine Gallagher, PhD, Director of the Cochrane Collaboration College for Policy, the team will conduct in-depth interviews with key health care specialists to understand patient barriers to treatment and determine better opportunities for improved health outcomes. Patient surveys will also be conducted to better understand their experiences of medical care, including barriers to care and perspectives on patient/provider communication. With fewer new physicians choosing to go into primary care, the need for this support for underserved populations is crucial to improving better health outcomes.
Written by Caroline Valentino