The 130th Annual Meeting of APHA

Abstract #46822

Peggy Honore, MHA, Division of Administration, Missouri Department of Health, Medical University of South Carolina, 920 Wildwood Drive, Jefferson City, MO 65109, 573-751-6014, HonorP@dhss.state.mo.us and Walter J. Jones, PhD, Department of Health Administration and Policy, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425.

With ever-increasing budgetary constraints, public health agencies need to develop more systematic means for improving the cost-effectiveness of their programs. One state department of health has begun to employ innovative methods of outcome-based contracting for program services. Linked to a comprehensive system of program evaluation, outcomes-based contracting can assist agencies in maintaining the highest level of services, promote effective resource use, and, by encouraging customer-focused services, increase citizen confidence in their public health agencies. The first application of this system has been in the area of maternal and child health (MCH). The purpose of the FY 2002 MCH contract between the State and its County Health Agencies is "to establish an integrated multi-tiered service coordinated population-based system capable of adapting to address targeted maternal / child health issues." Contract services are linked to current MCH Title V Block Grant performance measures, and state Department of Health strategic plan outcomes. Current work in this area is based on proposals developed by each Local Health Agency. Proposal criteria include credibility, public comprehension, measurability, compatibility with community goals, and data support. Milestones (ensuring accountability), short-term and long-term outcomes have been identified and negotiated in each State - Local Agency contract. Contracts are six years long, with a funding formula that transitions from an initial 100% guaranteed to 20% guaranteed / 80% outcomes-based. Challenges in implementing this system include the collection and utilization of valid outcomes data, continued good communication between the State and County Health Agencies, and the development of citizen support.

Learning Objectives: At the conclusion of this presentation, the participant should be able to

• Understand the current need for and the basic principles of outcomes-based contracting.
• Comprehend the linkages between outcomes-based contracting and program evaluation.
• Consider how outcomes-based contracting can be used to improve public health services in areas such as maternal and child health (MCH).
• Note the challenges to a successful outcomes-based contracting system.

Keywords: Contracting, Collaboration

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.