NF Quality Incentive Payment Program
Iowa is currently exploring the possibility of starting a Quality Incentive Payment Program (QIPP) for Iowa’s non-state government owned (NSGO) facilities. Eligible entities would need to be owned by either a city or the county to qualify for participation in the program.
As you may remember, IHCA made a couple attempts at kickstarting a program similar to this over the past six years. This program has some significant differences from the program that IHCA attempted. The basic premise of this type of program is that the NSGO can draw down additional federal funds, up to the upper payment limit or what Medicare would pay for the service, following an inter-governmental transfer (IGT) of funds that has been initiated to the state to cover the state share of the total payments. In this program, a provider would need to meet specific ownership and quality metrics to qualify for the additional add-on payments achieved through the QIPP program.
Current NSGOs would be eligible for the program immediately, from an ownership standpoint, as they would not need to undergo any changes in ownership. If a privately owned facility wants to partner with a NSGO, the transaction must occur prior to the application deadline, be completed at fair market value and meet ownership requirements per CMS as defined in 42 CFR 489.18(a).
The second qualification is meeting defined quality metrics to achieve additional funding. The state of Iowa’s current proposed quality measurement areas would include six different quality components and at least 13 different metrics for measurement of the quality. These metrics will be reviewed beginning July 1 and every six months thereafter. If a provider were to fail to meet the quality criteria, they would no longer receive the quality payments until they come back into compliance at a future review period. Providers who are enrolled in the program and meet quality criteria would then be eligible for the QIPP add-on payment, which is paid out to providers prospectively with the quarterly nursing facility case-mix rates beginning July 1 of each year.
The state is currently drafting a state plan amendment to send to CMS for approval of this program. IHCA has been in regular communication with Iowa Department of Human Services (DHS) regarding this program. Additional information and supplementary documents can be found at this webpage. DHS has also set up an email address for providers to submit additional questions at [email protected].
For questions, contact Brandon Hagen, VP, Reimbursement and Grassroots Advocacy, at 515-978-2204.