The Kentucky Initiative in Health Services Contracting: The Search for Contracting of Outcomes Measures

Abstract

This article is based on a research project that provided information and recommendations to the Kentucky Cabinet for Health Services concerning contracting for health services to help enhance contracting practices. The health agencies of many states have expended considerable effort to enhance their contracting practices, particularly in the areas of performance measurement, results reporting, and the use of web-based systems for contracting activities, collecting data, and reporting results. The motivation for improving the collection of performance measures is principally driven by the need to better assess the efficacy and cost effectiveness of programs and to meet federal grant requirements and the performance based budgeting requirements being implemented by many states. States appear to be adopting a variety of strategies. Some states have implemented performance measurement and reporting systems (such as report cards). Other states have implemented strategies of how to improve performance (performance improvement plans). A few states have actually imbedded performance standards in their contracts. An overview of these systems and discusses changes that have been implemented by the Kentucky Cabinet for Health Services in an effort to move toward better contracting is provided.