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Date ArticleType
10/3/2016 Payment/Reimbursement
Indiana Value Based Purchasing Discussions Start Up Again

On September 22, 2016, IHCA participated in a re-start of discussions on what Indiana’s Value Based Purchasing (VBP) methodology should include as part of the nursing facility base rate incentive as well as a potential VBP program in the NSGO NF supplemental payment program. The Indiana Division of Aging (DA) organized the meeting and representatives from Indiana Medicaid, the Indiana State Department of Health (ISDH), IU Medicine, and other organizations attended (click here for the agenda and invited persons).

The discussion was wide ranging and included review of the past VBP efforts, which have created the current system that exists in today’s nursing facility base rate (click here for a description of the current system). IHCA advocated that the Indiana Medicaid VBP program be altered so that alignment of incentives with other payor demands be achieved.  Changes in Medicare Part A, with bundling and ACOs, the increased presence of Medicare Advantage, and other preferred provider network formation are all pointing to the CMS 5 Star system and hospital readmissions, which our current Indiana formula misses the mark on. IHCA has heard from many members that they would like to see more quality outcomes measures in Indiana’s formula, and to that end, alignment at least with the Quality Measures in the CMS 5 Star system would be a place to start.

The Indiana DA expressed interest in exploring how a revamped VBP program could be used to improve focus on patient centeredness and patient preferences, including whether and how patient satisfaction could be part of a program.  The ISDH discussed potential revisions to the Report Card Score that they first described more than a year ago and how they intend to revisit that new methodology in this process. IHCA and other provider associations agreed that whatever is used in a revised VBP, the measures must be fair, objective, and able to be impacted by facility actions – measures that cannot be impacted by facility action are simply unfair.

The earliest possible date for a revised VBP program in the Indiana nursing facility base rate, or elsewhere, appears to be January 1, 2018. The Indiana Medicaid office and DA have ensured that providers will be given one year to plan for the changes once agreed upon and modeled. Stay tuned!