Medicaid; modifying quality measures used for nursing facility incentive reimbursement rate plan. Effective date.
Upon passage, SB412 will specifically impact the quality assurance provisions for nursing facilities by introducing a structured incentive to promote care enhancements. Under the new model, facilities will be required to reserve a portion of their per diem rates for quality assurance, motivating them to meet defined performance criteria like reducing the incidence of pressure ulcers and urinary tract infections. Additionally, the bill mandates the establishment of an advisory group that encompasses various stakeholders to evaluate and recommend quality measures regularly, thereby increasing transparency and ensuring responsiveness to the needs of residents.
Senate Bill 412 aims to amend the existing reimbursement rate plan for nursing facilities under the Oklahoma Medicaid program. The bill focuses on developing an incentive reimbursement structure that emphasizes improving resident outcomes and the overall quality of life for persons residing in these facilities. By modifying the terminology and quality measures in the current framework, the bill seeks to implement a pay-for-performance model, which will financially reward facilities that achieve specific quality metrics outlined by the Centers for Medicare and Medicaid Services (CMS). This change indicates a significant shift towards incentivizing higher standards of care within the state’s nursing facilities.
While the intent of SB412 is to improve care standards in nursing facilities, there may be potential contention surrounding the implementation and feasibility of the pay-for-performance system. Concerns could arise regarding the capacity of all facilities to meet the high bar for performance metrics, which may inadvertently disadvantage those struggling financially. Moreover, some advocates for nursing home advocacy may argue that the criteria set forth by the bill do not adequately address the diverse challenges that various facilities face in delivering quality care, particularly those that cater to vulnerable populations.