title: Minnesota's provider-initiated approach yields care quality gains at participating nursing homes.
abstract: Minnesota's Performance-Based Incentive Payment Program uses a collaborative, provider-initiated approach to nursing home quality improvement: up-front funding of evidence-based projects selected and designed by participating facilities, with accountable performance targets. During the first 4 rounds of funding (2007-10), 66 projects were launched at 174 facilities. Using a composite quality measure representing multiple dimensions of clinical care, we found that facilities participating during this period exhibited significantly greater gains than did nonparticipating facilities, in both targeted areas and overall quality, and maintained their quality advantage after project completion. Participating and nonparticipating facilities were similar at baseline with respect to quality scores and improvement trends, as well as acuity-adjusted payment, operating costs, and nurse staffing. Although self-selection precludes firm conclusions regarding the program's impacts, early findings indicate that the program shows promise for incentivizing nursing home quality improvement, both in facility-identified areas of concern and overall.
authors.forename: Greg
authors.initials: G
authors.lastname: Arling
authors.forename: Valerie
authors.initials: V
authors.lastname: Cooke
authors.forename: Teresa
authors.initials: T
authors.lastname: Lewis
authors.forename: Anthony
authors.initials: A
authors.lastname: Perkins
authors.forename: David C
authors.initials: DC
authors.lastname: Grabowski
authors.forename: Kathleen
authors.initials: K
authors.lastname: Abrahamson
mesh_terms: D006801:Humans; D008910:Minnesota; D009735:Nursing Homes / Q000191:economics / Q000592:standards*; D019982:Organizational Case Studies; D058996:Quality Improvement / Q000191:economics*; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D012052:Reimbursement, Incentive
keywords: Elderly; Long-Term Care; Medicaid; Organization and Delivery of Care; Quality Of Care