Medicaid nursing facility payment approaches
Medicaid nursing facility payment approaches to advance health equity and improve health outcomes.
This Center for Medicaid & CHIP Services (CMCS) Informational Bulletin (CIB) describes actions that states can implement using existing Medicaid authority. CMS encourages states to assess their approach to payments to long-term care providers and utilize flexibilities provided by section 1902(a)(30)(A) of the Social Security Act (the Act) in establishing Medicaid base and supplemental payments, as appropriate, to provide adequate, performance-driven nursing facility rates to ultimately achieve better health care outcomes and address longstanding inequities for Medicaid beneficiaries residing in nursing facilities. States can implement a number of initiatives immediately through the Medicaid state plan, waiver, or demonstration process, which are highlighted below. Through initiatives like these, we expect that Medicaid beneficiaries residing in nursing facilities will receive better care through the collaboration of CMS and states to realize the goals outlined in the White House Biden-Harris Administration’s Nursing Home Reform Action Plan.
Tsai, Daniel. “CMCS Informational Bulletin.” CMS, 22 Aug. 2022, www.medicaid.gov/federal-policy-guidance/downloads/cib08222022.pdf.
CMS: Medicaid Funding a ‘Key Lever’ to Improving Nursing Home Quality, Staffing
In line with the Biden administration’s nursing home reform initiatives outlined in February, the Centers for Medicare & Medicaid Services (CMS) is encouraging states to allocate Medicaid dollars toward improving staffing, and help the federal agency fully realize its goal of strengthening quality of care, accountability and transparency in the sector.
The agency listed several examples of states bumping up their Medicaid rates to support staffing and quality initiatives in a memo published on Monday – Illinois and California among them.
Illinois’s $700 million in facility staffing incentives, implemented this year, involve a data-driven staffing ratio program and wage incentive initiative – specifically the CNA tenure and promotion payments program to increase and maintain wages for certified nursing assistants.
Stulick, Amy. “CMS: Medicaid Funding a ‘Key Lever’ to Improving Nursing Home Quality, Staffing.” Skilled Nursing News, 22 Aug. 2022, skillednursingnews.com/2022/08/cms-medicaid-funding-a-key-lever-to-improving-nursing-home-quality-staffing.
CMS bulletin presses states on Medicaid nursing home spending
States should use their Medicaid authority to help drive better health outcomes among nursing home residents, the Centers for Medicare & Medicaid Services said in an informational bulletin issued Monday.
The agency’s Centers for Medicaid and CHIP Services said states should use already available tools to improve staff pay, training, and retention efforts. The bulletin, while encouraging state governments to do more to fund nursing homes and hold them accountable for quality care, does not impart any new requirements on states or providers.
CMS is urging states to tie Medicaid payments to quality measures that will improve resident care and safety and ensure nursing homes are adequately resourced and staffed. The bulletin directs states “as appropriate, to provide adequate, performance-driven nursing facility rates to ultimately achieve better health care outcomes and address longstanding inequities for Medicaid beneficiaries residing in nursing facilities.”
Marselas, Kimberly, and James Berklan. “BREAKING: CMS Bulletin Presses States on Medicaid Nursing Home Spending.” McKnight’s Long-Term Care News, 22 Aug. 2022, www.mcknights.com/news/cms-bulletin-presses-states-on-medicaid-nursing-home-spending.
