September 19, 2023

State of Connecticut to Implement Quality Payment Program

By Thomas Moore, Supervisor, Advisory Services

State of Connecticut to Implement Quality Payment Program Healthcare

The State of Connecticut continues to adjust its Medicaid reimbursement system, with the latest change coming from the announcement of a quality payment program set to take effect in rate year 2025. The objectives of this program are designed with goals of modernizing the rates being paid, establishing a framework to align direct care reimbursement with the needs of each provider based on the acuity of their residents, and providing incentives for nursing homes to admit and provide care to those in need of greater care.

There are still many questions to be answered about this program. Most important is how much of an impact this program will have on the Providers. We know currently that there will be an array of quality measures that the State will obtain to measure the quality score each facility will receive. Some quality measures that will be assessed are nursing hours per resident day, the acuity level of residents in the facility, and survey results.

The tough task ahead for providers is learning this new system and using it in a way that will both advantage them and allow them to provide the highest level of care possible to its residents. The quality payment program will be displayed on rates in rate year 2024 for informational purposes only. Providers will need to take advantage of the time they have to effectuate change in their quality payment before this program negatively impacts their rate.