The quality of nursing home care has been a concern of the general public, policy makers, and the nursing home industry for decades. Government has traditionally approached the problem through the regulatory process with fines or sanctions imposed on homes that deliver poor care. Recently, Medicare and several state Medicaid programs have adopted pay for performance models that reward nursing homes for better quality by linking payment to performance on standardized quality measures. Providers delivering the best care or showing the most improvement receive the highest payments. Pay for performance, in theory, should encourage providers to invest in better quality of care. Currently, a dozen states have implemented P4P programs with financial rewards based on various measures of performance such as staffing levels, inspection results, clinical quality measures, resident quality of life, consumer satisfaction and resident centered care. Well-designed nursing home Pay for Performance programs have the potential to improve care to all nursing home residents.
Myers and Stauffer has assisted several states in designing a Pay for Performance program that meets state specific goals and objectives including: