A Pay-for-Performance Initiative to Reduce Pediatric Psychiatric Inpatient Length of Stay

This column presents results of a pay-for-performance (P4P) initiative to reduce psychiatric inpatient length of stay for Medicaid-covered youths at eight hospitals in Connecticut in 2008 (N=715), 2009 (N=1,408), and 2010 (N=782). Compared with the 2007 baseline, average length of stay decreased by 25% (from 18.1 to 13.6 days) by the end of the P4P program, with concurrent nonsignificant decreases in 7- and 30-day readmissions. Readmitted youths tended to access postdischarge care sooner and use more community-based services during the first 180 days postdischarge. Additional research is needed, but the P4P program appears to have contributed to shortening inpatient stay without apparent adverse outcome on increases in postdischarge service use.