Emphasizing Quality in Long-Term Care: What Providers Need to Know for the Coming Year
As we look ahead to the upcoming year, one thing is abundantly clear: the emphasis on quality in long-term care is here to stay. Tammy Cassidy, our expert on long-term care trends, outlines the key factors that providers should be aware of and prepare for in the coming months.
Continuous Evolution of Quality Measures
Both the Centers for Medicare & Medicaid Services (CMS) and various state Medicaid programs are continuously modifying, expanding, and evaluating their quality measures. This includes initiatives like value-based purchasing and other quality-driven programs. The goal is to ensure that care provided in long-term care facilities meets high standards and delivers better outcomes for residents.
State-Level Quality Incentive Programs
Some states have already implemented quality incentive payment programs. For example, Ohio's program directly ties Medicaid reimbursement to the quality measures met by facilities. This means that facilities achieving higher quality standards can see substantial financial benefits. In some cases, this can mean an increase of up to $56 per resident per day, which is a significant impact on the bottom line.
Financial Implications and Future Data Collection
Quality measures are not just about meeting standards; they also have direct financial implications. CMS is actively collecting data that will impact Medicare Part A rates for the 2026 fiscal year, with expansions planned for 2027 and 2028. This data collection is part of an ongoing effort to refine and improve the reimbursement system based on the quality of care provided.
Preparing for the Future
For providers, the focus on quality means staying ahead of these changes and being proactive in improving care standards. Here are some steps providers can take to prepare:
Stay Informed
Keep up with the latest updates from CMS and state Medicaid programs regarding quality measures and reimbursement changes.
Invest in Training: Ensure that staff are well-trained and equipped to meet new quality standards. This includes utilizing resources like our new employee training videos.
Enhance Care Practices: Continuously evaluate and improve care practices to meet and exceed quality benchmarks.
Leverage Data
Use data analytics and other technological tools to monitor performance and identify areas for improvement.
Conclusion
The emphasis on quality in long-term care is more than a trend; it’s a fundamental shift that is reshaping the industry. By understanding the evolving quality measures and preparing accordingly, providers can not only meet new standards but also reap significant financial rewards. As Tammy highlights, the future of long-term care is bright for those who prioritize quality and continuous improvement.
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