Pay For Performance In Nursing Homes

Pay for Performance

The aim of the pay for performance program in nursing homes is a means of ensuring an improvement in the quality of care that is received by consumers. The implementation of pay for performance in these institutions gives them the impetus to improve their standard of care given, in relation to the perspective incentives to be received. According to Briesacher et al (2009), approximately 3 million individuals will depend on the services of a nursing home throughout the year. However it is estimated that one in five of these institution will be cited for deficiencies which cause harm or allows harm to occur.

Pay for performance (“P4P”) may be defined as a financial incentive given to healthcare providers or facilities as a

The Centers for Medicare and Medicaid Services is according to Briesacher et al (2009), is thought to be the principal consumer of nursing home services.

Pay for Performance in Nursing Homes

Briesacher et al (2009), identified in their article that enough information was not available on the use and impact of pay for performance in nursing homes. It was to this extent that in the summer of 2009 there was an implementation of a pay for performance I nursing homes in a few States. The information which was readily available indicated inconsistencies in outcomes and quantity of care. The incentives awarded had no clear demarcation for reason associated with awards. There was no data to validate these awards. These incentives ranged from a flat rate of $0.25 to 5 percent per consumer.

In an effort to garner information on present and past programs of pay for performance in nursing homes, Briesacher et al conducted and extensive research of internet sites as well as a last ditch effort of interviewing individuals from the CMS, MedPAC, and the Department of Veterans Affairs to access as much information as possible. The programs identified were further analyzed if they met the criteria set forth by the researchers. The criteria were as

Although incentives are granted based on these measures, not all facilities are or were able to meet and keep these standards. These standards are in line with those required for compliance with required certified nursing homes as dictated by State and federal regulations. These measures are as listed below.

• Staffing – what is the ratio of staff turnover

• Performance on an institution audit – all aspects of the institution is up to code

• Acceptable quality of care is given – no consumers presented with pressure ulcers or complaints of staff employing the use of restraints

• Institution demonstrates efficiency in operations

• Medicaid recipients welcome

• Consumer satisfaction

• Consumers are afforded comfort and privacy

• Consumers report positive outcomes

Conclusion

As discussed by Briesacher et al there is limited information on the success or failure of P4P in nursing homes. There is also no definite evidence indicating that P4P results in a more efficiency deliver of care, or a better quality of care. One must however, remain cognizant that the full implementation of P4P in nursing homes is still in the initial stage. This therefore means that a full analysis of this incentive program would not be qualified at this point in