Payers across the health care spectrum have begun transitioning from paying for quantity toward paying for quality. These value-based payment (VBP) programs vary in scope and focus, but generally share the goals of improving cost-savings and linking payments to value rather than volume. Many states have implemented VBP programs that provides payment incentives to nursing facilities for achieving certain goals; however, little is known about how VBP programs for Medicaid-covered nursing facility care are designed, the specific goals states are trying to achieve with these, and whether they are successful in achieving their stated goals. This exploratory study sought to understand which states use value-based purchasing programs as part of their nursing facility Medicaid payment; what are the goals of VBP programs and have states achieved their goals; and what are the key elements of VBP programs.
This research was conducted under contract #HHSP233201500039I between HHS/ASPE’s Office of Behavioral Health, Disability, and Aging Policy (BHDAP) and Research Triangle Institute. Please also visit the ASPE Long-Term Services & Supports/Long-Term Care page for additional research in this area.