Managed Care Incentive Payment Program

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.

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.