Minnesota's Nursing Facility Performance-Based Incentive Payment Program: an innovative model for promoting care quality.
OBJECTIVE
Minnesota's Nursing Facility Performance-Based Incentive Payment Program (PIPP) supports provider-initiated projects aimed at improving care quality and efficiency. PIPP moves beyond conventional pay for performance. It seeks to promote implementation of evidence-based practices, encourage innovation and risk taking, foster collaboration and shared learning, and establish a solid case for investing in better quality from the perspective of the state, providers, and consumers. We explain PIPP rationale and design, describe projects and participating facilities, and present findings from interviews with project leaders.


METHODS
Provider-initiated projects lasting from 1 to 3 years are selected through a competitive process and are funded for up to 5% of the daily operating per diem rate. Providers are at risk of losing up to 20% of their project funding if they fail to achieve targets on state nursing facility performance measures.


RESULTS
Minnesota has made a major investment in the PIPP by supporting 45 individual or collaborative projects, representing approximately 160 facilities and annual funding of approximately $18 million. Projects involve a wide range of interventions, such as fall reduction, wound prevention, exercise, improved continence, pain management, resident-centered care and culture change, and transitions to the community.


CONCLUSIONS
The PIPP can serve as a model for other states seeking to promote nursing facility quality either in combination or in place of conventional pay-for-performance efforts.
Nursing Facility Rates and Policy Division, Department of Human Services, St Paul, Minnesota 55164-0973, USA. valerie.cooke@state.mn.us
Valerie
V
Cooke
Greg
G
Arling
Teresa
T
Lewis
Kathleen A
KA
Abrahamson
Christine
C
Mueller
Lisa
L
Edstrom
D008910:Minnesota; D008962:Models, Theoretical; D009735:Nursing Homes / Q000592:standards*; D019982:Organizational Case Studies; D011785:Quality Assurance, Health Care / Q000191:economics*; D012052:Reimbursement, Incentive