Ohio Medicaid ups the ante on nursing homes

Ohio’s Medicaid program recently began offering the country’s largest financial incentive to nursing homes for providing quality services to residents (Source: Ohio Medicaid Program Raises Stakes For Nursing Homes, Kaiser Health News, Aug. 14, 2012). Previously, nursing homes in Ohio were eligible to earn a small incentive bonus of 1.7 percent of the daily payment rate. Under the new policy, almost 10 percent of a nursing home’s daily Medicaid payments will depend on the facility meeting five of 20 quality standards including resident and family satisfaction, medical complications, and staffing levels.  Other measures address nursing home residents’ freedom to make their own choices, inclusion in setting goals of care, and the opportunity to discuss their end-of-life preferences. 

Critics of the initiative say the threshold for receiving incentive payments has been set too low to result in any meaningful improvement. According to John Alfano, president of Leading Age Ohio which represents not-for-profit long-term care providers, "This system rewards performance at a minimum level, not excellence." Others question whether the performance measures are appropriate quality indicators.

According to Bonnie Kantor-Burman, director of the Ohio Department of Aging, the state plans “to up the ante over time. After guidance, technical assistance, and engaging consumers on these issues for a year or two, we will expect more."