Texas Quality Incentive Payment ProgramQIPP operates as part of the Texas Healthcare Transformation and Quality Improvement Program Waiver (the waiver), which provides health care services delivered through MCOs. QIPP is designed to improve quality and innovation in the provision of nursing facility services, and provides incentive payments to nursing facilities that meet performance requirements on specified quality measures. According to the State agency’s request to CMS for QIPP approval, payments from MCOs to qualified nursing facilities would “be based on improvements on specific quality measures.” The State agency also stated that nursing facilities “must make incremental improvements toward preset goals to qualify for payments.” Unlike the payments that were made under the UPL Program and MPAP, QIPP payments are available to private nursing facilities as well as NSGO facilities. Once appropriately claimed by the State, Federal regulations do not dictate how QIPP payments must be used by NSGE, NSGO facilities, or privately owned facilities.QIPP payments are comprised of three components. Component One payments are available only to NSGO facilities and are calculated to equal 110 percent of the IGTs that NSGEs provide to the State agency as the State share of QIPP funding. Texas defines an IGT as a “transfer of public funds” such as “taxes, assessments, levies, investments,” or “other public revenues.” Component One payments are made to NSGEs each month that NSGO facilities submit a Quality Assurance Performance Improvement (QAPI) Validation Report to the State agency. These payments are retained in full by the NSGEs. Component Two and Component Three payments are available to all QIPP-participating nursing facilities that meet individual performance requirements (described below), and are based on the amount of QIPP funding available after Component One payments are made. In addition to Component One, Component Two, and Component Three payments, all QIPP nursing facilities are eligible for “lapse funds.” Lapse funds are funds that are not distributed because one or more nursing facilities failed to meet QAPI reporting requirements or quality metrics. Lapse funds are redistributed to all nursing facilities based on each nursing facility’s proportion of the combined total QIPP-earned Component One, Component Two, and Component Three funds. MCOs retain a small percentage of the payments and lapse funds, and pay the balance to NSGEs and private nursing facilities.In its first year, 428 NSGO facilities and 85 private nursing facilities participated in QIPP, and budgeted expenditures for QIPP totaled $400 million. In the second year, 460 NSGO facilities and 95 private nursing facilities were eligible to participate in QIPP, and the budgeted expenditures totaled $446 million. On February 5, 2019, the State agency announced that it would allocate $600 million to QIPP for year 3 (State FY 2020). In the third year, 459 NSGO facilities and 339 private nursing facilities were eligible to participate in QIPP.
TX,
United States
