Skilled NF Pay-for-Performance, Home Care Growth

In 2009, we blogged about CMS’s cash incentive program to improve quality of care in nursing homes. CMS asked Arizona, Mississippi, New York, and Wisconsin to participate. Facilities with the highest scores as well as the greatest performance would receive performance payment.

McKnight’s reports that after four years, results are mixed (apparently Mississippi chose not to participate). CMS released a report about the program’s first-year results. An excerpt:

Although the demonstration is still under way and overall evaluation results are not yet available, several of the participants have reported improvement in their quality measures. For example, one reported that it decreased the incidence of pressure ulcers from 1.75 percent of residents to 0.3 percent of residents by implementing several facility-wide quality initiatives, ranging from improving staff education to ensuring that residents had proper footwear to prevent foot ulcers (Gurwin Jewish Nursing, 2010). In addition to lower rates of pressure ulcers, the SNF also noticed an improvement in the length of time required for pressure ulcers to heal. After implementing a similar program to lower the use of physical restraints on residents, and through better staff education, family involvement, and care coordination, use of restraints was reduced by half within one quarter of the year.

In other news—we’ve blogged many times about the retiring Baby Boomer generation and the pressure it will exert on health care providers, particularly long term care providers. Given the shortage of primary care physicians and the Affordable Care Act’s goal for states to expand Medicaid, the problem will grow. An excerpt from the AP story:

Agencies that supply home health workers blame states and the federal government for failing to increase reimbursement rates for Medicaid and Medicare patients at a time when costs are going up.

Home health services are an easy target for cuts because they’re not required by federal law, and legislators in states with big deficits say they have no choice but to cut Medicaid spending, the second-costliest item for states behind education.