Incentives for Quality

Patient Outcomes

McKnight’s had a good article on a recent proposal by the Medicare Payment Advisory Commission (MedPAC). This will replace the current value-based purchasing program with a more equitable, value-incentive model. MedPAC delivered its annual report to Congress. The report includes a recommendation to eliminate the current SNF VBP with an alternative incentive model that rewards providers based on the quality of care.

The recommended replacement would score SNFs based on multiple “performance measures focused on patient outcomes”.  This will increase quality of care.  The commission in the past has also argued the switch would ultimately result in more equitable payments across SNFs with different mixes of patients. The change should be budget neutral if adopted but that is what they said about PDPM.

Infection Control

Nursing homes have been vulnerable to lethal Covid-19 outbreaks. More than 135,000 residents have died from Covid-19. One-fifth of the total U.S. toll, even though fewer than 0.5 percent of Americans live in a long-term care facility.

When vaccines became available nursing home staff and residents were first to be eligible and the death rate plunged. Now, all nursing homes must require staff to get vaccinated to keep their jobs. Chiquita Brooks-LaSure, the CMS administrator, stated in a press release:

“Keeping nursing home residents and staff safe is our priority. The data are clear that higher levels of staff vaccination are linked to fewer outbreaks among residents, many of whom are at an increased risk of infection, hospitalization, or death.” 

The nation’s largest nursing home operator, Genesis, was able to get 100% of their 40,000 caregivers vaccinated. The company did not reveal if any employees left because of the requirement. Many were happy tha tthe rest of the staff were now safe. The U.S. Bureau of Labor Statistics latest jobs report stated that 380,000 workers at residential care facilities lost their jobs since February 2020 when the COVID-19 pandemic began.