Managed Care Incentive Payment Program
Learn how the AI-generated research projects were createdOverall Conclusion
LDH’s design and lack of oversight of the MCIP program led to the majority of MCIP funds being paid for activities that do not have a direct, measurable result for how they improve access to healthcare, improve quality of care, or enhance the health of Medicaid beneficiaries.
Source Document
Audit Scope
Evaluation of LDH’s design and oversight of the Medicaid Managed Care Incentive Payment (MCIP) program, covering September 2019 through March 2024.
Key Findings Summary
LDH’s use of Intergovernmental Transfers (IGTs) allowed approximately $1.93 billion in federal funds to be obtained without state general funds and with minimal risk to contributing entities.
LDH did not monitor how MCIP funds were used by MCOs or Quality Networks, leading to substantial funds ($1.08 billion) being spent on non-incentive activities.
The MCIP program total cost was about $2.39 billion from Sept 2019 through March 2024.
View the Findings tab to see all 7 findings
AI-Assisted
AI Scope Summary
Future Medicaid audits could build on MCIP findings by evaluating whether consolidating AIAs and standardizing milestones across incentive programs improves accountability, efficiency, and measurable health outcomes; assess the continued appropriateness of IGT-based non-federal funding and explore alternative funding models.
AI-Generated Insight
The MCIP program demonstrates how incentive programs can drive funding to healthcare providers but also highlights critical gaps in governance and accountability when milestones are not clearly tied to measurable outcomes; the report supports pursuing uniform AIAs and stronger monitoring to improve efficiency and health outcomes.
Audit Objectives
To evaluate LDH’s design and oversight of the Medicaid Managed Care Incentive Payment (MCIP) program.
Audit Findings (7)
LDH’s use of Intergovernmental Transfers (IGTs) allowed approximately $1.93 billion in federal funds to be obtained without state general funds and with minimal risk to contributing entities.
LDH did not monitor how MCIP funds were used by MCOs or Quality Networks, leading to substantial funds ($1.08 billion) being spent on non-incentive activities.
The MCIP program total cost was about $2.39 billion from Sept 2019 through March 2024.
LDH’s design and oversight gaps led to MCIP funds being paid for activities not directly tied to measurable improvements in access, quality, or health outcomes for Medicaid beneficiaries.
The MCIP design created two separate Quality Networks (Louisiana Quality Network and Quality and Outcome Improvement Network) with different AIAs and milestones, hindering comparability and consistency of funding.
LDH prioritized funding for non-milestone activities and non-measurable milestones, with a smaller share for measurable milestones, reducing focus on outcome-based results.
QIN’s contract for management services raised constitutional concerns due to lack of documentation to support services rendered.
Recommendations (5)
Evaluate the MCIP structure and consider consolidating AIAs to a uniform plan across Quality Networks.
Re-evaluate the policy on the share of MCIP funds allocated to non-milestone activities that do not directly affect quality of care.
Update milestones to emphasize measurable outcomes in each year of AIAs, rather than mainly in later years.
Amend LDH contracts with MCOs to establish terms on MCIP fund usage.
Regularly monitor MCIP fund use to ensure efficiency and alignment with federal and state law.