Texas Health Care Briefing No. 8
Texas’ “investment” in nursing home quality yields immediate results
Texas’ limited supplemental program incentivizing the quality of long term care is already returning positive results for the nursing homes fortunate enough to be included.
In just the first six months of HHSC’s Quality Incentive Payment Program (QIPP), nursing homes eligible to participate have realized improvements across all four of the quality measures to better than the established benchmark national averages.
“These across-the-board improvements prove what we have known all along — Texas nursing homes are worth the investment,” said Kevin Warren, president and CEO of the Texas Health Care Association. “Texas’ long-standing experiment with regulating its way to improving long term care hasn’t worked nearly as well as investing in quality.”
At the start of QIPP in 2018, the average Texas nursing home participating in the program performed below national average benchmarks on three of the four program’s quality metrics: the number of falls with major injuries, the number of pressure ulcers, the number of residents on antipsychotic medication and the number of residents requiring physical restraints.
In just the first six months of QIPP, nursing homes participating realized improvements across all four of those key quality measures. Overall, nursing homes receiving QIPP-enhanced reimbursements are now performing better than established benchmark national averages in all four measures.
By the end of the second quarter, the average Texas QIPP participant metric score had a 33 percent relative improvement from the program’s baseline. The number of high-risk, long stay residents with pressure ulcers dropped 12 percent. Residents on antipsychotic medication declined by 25 percent. Residents suffering major injuries from falls decreased by 12 percent. (NOTE: These statistics have been corrected from the print version that was distributed to the Capitol, which under-reported the program’s success.)
A full 80 percent of nursing homes participating in QIPP met the state’s goal of improving by 10 percent from their baseline, or by having a quality measure score better than the national average benchmark.
While HHSC is currently considering rules changes to expand the eligibility for QIPP, more must be done to ensure that all Texas nursing homes have access to adequate funding, Warren said.
“QIPP proves that investing in quality long term care works,” Warren said. “Providing the opportunity for adequate reimbursements to all Texas nursing homes continues to be our goal.”