Value Based Purchasing – CMS Issues Request for Additional Information

On August 14, 2013, CMS issued a Request for Additional Information to the Indiana Medicaid Office concerning the State Plan Amendment (SPA) to implement the Value Based Purchasing (VBP) program. Click here to read the CMS letter.  The VBP program is the new methodology for an add-on to the Medicaid NF rate that is based on Report Card Scores, nursing hours per resident day, and staff retention and turnover. Click here for details on the VBP program.  In the CMS letter, the agency suggested to Indiana Medicaid that the VBP program incorporate certain MDS Quality Measures, even though those Quality Measures were not part of the original submission.  CMS also requested that additional detail be added to the SPA concerning calculation of the various VBP domains. 

Indiana Medicaid responded to the CMS letter on September 9th. Click here to read Indiana Medicaid’s response.  With the submission on September 9th, CMS has 90-days to respond, so we expect an approval or denial in early December of this year.  Regarding the incorporation of Quality Measures, Indiana Medicaid agreed with CMS that Quality Measures should be incorporated into the VBP program at a future date.  To that end, IHCA has been part of recent meetings with Indiana Medicaid and the Division of Aging to begin discussions on how Quality Measures could be incorporated in the future. 

Lastly, as you are aware, Indiana Medicaid and its contractors conducted satisfaction surveys of residents, family and staff this summer.  That data is not yet available for review or analysis, but will be in the coming month or so.  Once IHCA has this data, we will report back to the membership.
If you have any questions, please contact Zach Cattell at 317-616-9001 or zcattell@ihca.org.