Scenario: A family physician sees approximately 29 patients per day (Gottschalk and Flocke 2005, 490-491). Of these 29 patients per day, five are Medicaid patients and three of those Medicaid patients are well-babies. The state Medicaid plan has implemented P4P and is utilizing the HEDIS® measures. One of the measures is that well babies have six office visits by 15 months. At the current time, the family physician receives a $100 bonus per baby with six or more well-baby visits by 15 months. The Medicaid program has proposed two methods of restructuring the incentives:

$25 bonus for each set of three well-baby visits to the family physician and a $15 gift certificate for each set of two well-baby visits to the parents

$100 bonus per baby receiving fifth well-baby visit and polio, hepatitis B, and Haemophilus influenza type b (Hib) vaccines by 13 months; and a second $100 bonus for the sixth well-baby visit by 15 months and relevant vaccines Of the three methods, current and two proposed, which method would result in the highest financial reward for the family physician? Which method would result in the lowest financial reward for the family physician?