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05/15/2019

Details Emerge on House Quality Incentive Program

Last week, the Ohio House passed its Sub Bill, which made significant investments in aging services, including over $150 million in nursing facility reimbursement, channeled through a quality incentive program. The quality incentive program would evaluate nursing facility’s performance on four measures selected from the Centers for Medicare & Medicaid Services (CMS)’ Five-Star program, which are:

  • Percentage of residents whose ability to move independently worsened 
  • Percentage of high risk residents with pressure ulcers
  • Percentage of residents who have/had a catheter inserted and left in their bladder
  • Percentage of residents with a urinary tract infection

Furthermore, the program would exclude providers with low occupancy from receiving any increase, defining low occupancy as under 80-percent for the second half of state fiscal year 2020, and below the statewide average occupancy rate for state fiscal year 2021. It would also exclude those providers whose quality scores on the four measures fell in the bottom percentile.

The program would assign points for each measure, to calculate a total quality score for each provider, distributing an overall increase of 2.4% to the line item between providers that have not been excluded based on occupancy or low performance.

LeadingAge Ohio is in conversation with Senate leadership on the proposal, and is working to model the impact of the quality incentive program on members. LeadingAge Ohio encourages members to reach out with specific feedback on the proposal. It is important to note that this is a proposed program and changes are likely as the budget bill moves to the Senate. Due to the Memorial Day holiday, the next LeadingAge Ohio bi-weekly Budget in Brief call will take place on Tuesday, May 28 at 10am by dialing (800) 582-3014; passcode: 60427031#. Questions on this or any budget item may be directed to Susan Wallace, Director of Government Relations and Public Affairs at swallace@leadingageohio.org.

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Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.