VBP Update

The IHCA Board met on November 5 to discuss the State’s proposal to alter the VBP Add-on methodology by removing the Satisfaction Surveys and allocating those points to the Report Card Score (RCS) portion of the add-on.  In agreement with the IHCA Payment Committee’s recommendation, the IHCA Board agreed that the State should implement the VBP Add-on without the Satisfaction Surveys included, resulting in a VBP Add-on where 58% of the add-on is based on the RCS, 10% is based on Nursing Hours Per Resident Day, and 30% is based on retention and turnover of RN/LPNs, CNAs, Administrators, DONs,  and 2% is based upon contracting with an AMDA Certified Medical Director (for more detail on the VBP domains, see http://www.nxtbook.com/nxtbooks/naylor/INHB0112/index.php?startid=6#/6).

However, the Board also directed IHCA staff to continue work on changing the VBP Add-on methodology so that therapy hours are counted in the Nursing Hours Per Resident Day domain, and so that Administrator and DON promotion within a company does not count as turnover.  IHCA has been on record with both of these issues in the past and has communicated again with the State on these points. IHCA Staff is preparing to take additional steps to secure changes in these areas.

Faith Laird, Director of the Division of Aging, emailed IHCA a revised model of the impact that the revised VBP Add-on would have to nursing facilities.  The revisions include the 80th and 20th percentile values for measures where applicable.  In addition, the State indicated that it reviewed CNA turnover rates between urban and rural facilities to test the assertion that urban facilities have higher turnover rates than rural facilities, therefore supporting the need for a probationary period during which turnover would not negatively impact performance in the turnover domain.  Based on the State’s data from nursing facility cost reports, CNA turnover in urban areas measured 1.58 Quality Points and rural areas measure 1.57 Quality Points.

IHCA has requested additional information from the State regarding the data behind the Nursing Hours Per Resident Day calculation, modeling on how the revised methodology would impact the Profit Incentive Add-ons, and detail on actual performance of facilities in each of the domains rather than how many Quality Points were earned by each facility.

Please contact Zach Cattell at zcattell@ihca.org or 317-616-9001 with any questions.