New York Extends Medicaid Payment Incentives through 2024 for COVID-19 Vaccinations in Adults and Children Ages 6 Months and Up

The state has included COVID-19 vaccination performance metrics in its 2024 quality assurance measures, which are used in setting payments to health care providers under value-based payment programs.

As New York State continues its conversion from a fee-for-service model to value-based payments (VBP) for publicly funded health care, it has introduced a detailed performance metric to track and incentivize COVID-19 vaccinations.

The measure is included in the state’s quality assurance performance metrics, which are used in determining payments to health care providers working under VBP contracts. They include providers contracted with Medicaid managed care organizations (MCOs) and other publicly funded plans.

In contrast to fee-for-service payment schemes, in which insurers and private payers simply pay a fee for each medical appointment, test, or procedure, VBP programs determine payment amounts according to providers’ ability to meet performance and reporting goals.

The New York State Department of Health publishes an annual list of quality assurance metrics for reporting purposes. Medicaid MCOs and other insurers collect