This brief presents several ways that Medicaid reimbursement rates for nursing-home and community-based services can be restructured to provide financial rewards or incentives for high productivity or superior performance with respect to staffing adequacy, stability, and care quality. Provides examples that are already in use in numerous states.
Key Takeaways
A higher rate can be paid to those providers who achieve standards or performance that exceeds a stated baseline.
By creating financial rewards for higher quality, performance, and outcomes, reimbursement rates can be used to generate competitive pressures that push quality up and costs down.
Procurement and contracting standards can be used to establish minimum benchmark standards for providers to participate in particular programs.
