Measuring Quality Contraceptive Care in a Value-Based Payment System

Prepared with the Planned Parenthood Federation of America

In 2016, the National Quality Forum endorsed three contraceptive care quality measures to assess the degree to which women access effective methods of contraception. This endorsement is an important milestone, providing the first evaluation metric on the availability and use of effective contraception. Beginning with the 2017 measurement year, the Centers for Medicare & Medicaid Services (CMS) incorporated two of the three contraceptive care quality measures into its core Medicaid measures set for adults and children. At the same time, states are incorporating the measures into Medicaid value-based payment (VBP) models that reward providers for increasing access, improving outcomes and lowering costs.

As Medicaid programs consider the use of contraceptive quality care measures, including with respect to VBP program incentives, Medicaid policymakers and their plan and provider partners must be vigilant in ensuring women’s agency in their contraceptive choices. This vigilance is critical in light of the preference-based decision of contraceptive use—and a history of practices limiting women’s contraceptive choices and even the decision of whether to become pregnant. Studies show such practices persist—most often with respect to women with low incomes, women of color and immigrants—and can cause distrust of the medical establishment.

In a new issue brief prepared with the Planned Parenthood Federation of America, Manatt Health discusses the benefits of measuring contraceptive care quality and describes guardrails state policymakers and Medicaid managed care organizations (MMCOs) will want to consider to ensure that the measurement of contraceptive care quality does not inadvertently incentivize providers or MMCOs to encourage women to use certain types of contraception.

To read the full brief, click here.



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