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More than half of state Medicaid programs have at least one pay-for-performance (P4P) plan, and nearly 85 percent will have one within the next five years, says The Commonwealth Fund, a healthcare research organization that surveyed all state Medicaid directors. Nearly three quarters of existing P4P plans involve managed care or case management, while other P4P programs are designed to encourage the use of high-tech resources such as e-prescribing. Most state Medicaid directors say bonuses and differential reimbursement rates are the most effective incentives for them. Other common incentives include grants and public reporting of performance.