DOH Issues Quality Pool Materials
DOH has advised nursing homes that the facility-specific results of benchmark quality pool calculations are now available on the Health Commerce System (HCS). These calculations are based on the prior year’s data and are intended to give homes an idea of the quality pool criteria calculation and where they stand relative to other homes in the state based on those data.
Note that these are benchmark data only and that the actual 2013 quality pool distribution will be based on newer data that are not yet available.
The $50 million to fund the 2013 quality pool will be collected from all homes. It will be distributed to homes whose results fall into the top three quintiles (i.e., top 60 percent of homes in the state) based on the distribution methodology. It is not yet clear exactly how and when DOH will collect the $50 million, but it is likely that it will be a bottom-line, per-day reduction to each home's Medicaid rate. The cut would be roughly $1.70 per 2013 Medicaid resident day if implemented in a uniform way. If it is indexed to the Medicaid rate, homes with a Medicaid operating rate higher than the state average (approximately $185) will see a cut higher than $1.70. The cut is likely to be implemented at the same time as quality pool payments are made. Because some of the data on which the distribution is based will not be available until later in the year, these cuts and payments are likely to occur towards the end of 2013.
Because the amount each home would receive is dependent on the Medicaid revenue and days of all quality pool recipients, it is impossible to estimate a facility-specific distribution at this time. However, with 360 homes sharing $50 million, the average distribution will be about $140,000 with those in the top quintile receiving more and those in the third quintile receiving less.
The DOH email announcing the availability of the reports is copied below. The materials sent include guidance on interpreting the benchmark report. Homes need to download their actual benchmark report from the HCS based on the instructions provided in the “Dear Administrator” letter.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841
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From: Nursing Home Quality Pool BML <nhqp@health.state.ny.us>
Subject: NYS Nursing Home Quality Pool
Good afternoon -
In anticipation of the 2013 Nursing Home Quality Pool (NH QP), the Office of Quality and Patient Safety has completed the benchmarking of the 2013 Quality Pool parameters using 2011-12 data and the results are posted on the Health Commerce System (HCS). Nursing homes will be able to use these results to gain an understanding of the Quality Pool methodology and to assess their current performance. These results are for benchmarking purposes only.
The following types of facilities are excluded from the Quality Pool and therefore will not have a one-page report posted on the HCS: Non-Medicaid facilities, CMS designated Special Focus Facility, Specialty Facility, Continuing Care Retirement Communities and Transitional Care Units.
There are three attachments to this email. The first attachment is the Administrator letter and it provides background and instructions on accessing your facility's one-page report. The second attachment outlines the methodology for the 2013 NH QP and the third attachment provides instructions on how to interpret your facility’s one-page report.
We are planning on conducting regional conference calls with the nursing homes and their associations to review the methodology, your facility report and to answer any questions you may have in the next few weeks. More information will be forthcoming on these conference calls.
Sincerely,
Raina Josberger
Nursing Home Quality Pool BML
New York State Department of Health
Office of Quality and Patient Safety