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Colorado established two value-based payment arrangements with the goal of improving maternity care for Medicaid enrollees. The Hospital Quality Incentive Payment (HQIP) Program is a voluntary payment arrangement for hospitals providing services to Medicaid enrollees (CHASE 2019b).1 It offers incentive payments to hospitals if they meet certain quality measures, which include measures on maternal health and perinatal care. In November 2020, Colorado launched the Maternity Bundled Payment Program (CHASE 2020a). 2 This voluntary model creates a payment incentive for obstetrics providers for performance on cost and quality metrics. Once fully implemented, providers will be financially penalized if they have high costs (i.e., costs above what the state consider to be acceptable) and financially rewarded if they have low costs (i.e., costs below what the state considers to be commendable). Under contract with MACPAC, RTI International conducted interviews and examined five states (Arkansas, Connecticut, Colorado, North Carolina, and Tennessee) implementing value-based payment initiatives to improve maternity care in Medicaid. This case study includes an overview of the Colorado HQIP and maternity bundled payment program, details how each model is defined, describes the payment methodologies, and summarizes the available research on the models’ effects on cost and quality. 3 MACPAC has also published case studies for the other study states, as well as an issue brief summarizing the key findings (MACPAC 2021a–e).
