Paying for Nursing Home Quality: An Elusive But Important Goal.

Keywords: Nursing homes; Pay; for; performance; Payment EN Nursing homes Pay for performance Payment S22 S27 6 02/16/23 20230102 NES 230102 On a given day, almost 1.3 million individuals receive care from approximately 15,000 nursing homes nationwide ([20]). Although these models have not focused specifically on nursing home care, the elimination of post-acute nursing home services has been the major source of savings within these demonstrations, with a recent commentary terming nursing homes "the piggy bank" for these APM payment models ([2]). History of Nursing Home Value-Based Payment Initiatives The first documented attempt to improve nursing home quality through incentive payments was a randomized experiment conducted in 36 San Diego-area nursing homes over the period of 1981 to 1983 ([49]). Nursing homes that serve vulnerable populations are less likely to receive bonus payments and more likely to be penalized, thereby punishing facilities that care for a greater share of Medicaid residents and historically marginalized communities, as dual eligibility, racial minority, and ethnic minority statuses are significant predictors of admission to the lowest-rated facilities in Medicare's star rating system ([52]). [Extracted from the article]