Ohio has launched the nation’s largest state program to base part of nursing home reimbursements on quality.
Almost 10 percent of a nursing home’s Medicaid reimbursements now depend on the facility’s performance on 20 quality measures, including pain management, nursing staff-to-resident ratios, rates of sores and pressure ulcers, resident-centered scheduling of daily tasks, facility safety and cleanliness, and resident and family satisfaction.
The program offers the state’s 970 nursing homes a much larger incentive than in in the past—10 percent vs. the previous 1.7 percent. Facilities that can’t meet at least five of the 20 quality measures will not receive the full Medicaid reimbursement.
Some wonder if the Ohio initiative goes far enough, since nursing homes only have to meet one-quarter of the quality measures to qualify for the payments.
“It just doesn’t seem that (nursing homes) will have to stretch themselves enough, and I’ll be advocating for raising the threshold in the future,” said Beverley Laubert, Ohio’s long-term care ombudsman, in an article published by KHN.
Nine other states have enacted nursing home pay-for-quality programs: California, Colorado, Georgia, Iowa, Kansas, Nevada, Oklahoma, Utah and Vermont.