QIPP: Measuring Success

Before we can take an in-depth look into the partnership between hospitals and nursing homes and facilities under the Quality Incentive Payment Program (QIPP) – most specifically, its innerworkings between Olney’s Hamilton Hospital and nursing homes under the Olney-Hamilton Hospital District – a basic understanding of additional aspects of the QIPP program, such as its standards of quality and measures of success, are needed. The Centers for Medicare & Medicaid (CMS) launched their Five-Star Quality Rating System in 2008 to, according to their publicly-released year three report of the system, provide residents and their families with a simple way to understand assessments of nursing home quality and make meaningful distinctions between high-quality and low-quality performances of nursing homes. Their report also states that the system utilizes three domains of quality: health inspection services, staffing levels and quality measures derived from the Minimum Data Set (the U.S. federally mandated process for clinical assessment of all residents in Medicare or Medicaid-certified nursing homes and facilities.)

According to the Texas Health and Human Services website, the four quality measures involved with the QIPP program and under the Five-Star Quality Rating System are high-risk long stay residents with pressure ulcers, percent of residents who received an antipsychotic medication (long-stay0, residents experiencing one or more falls with major injury and residents who were physically restrained.

For the second year of the QIPP program, measurements of improvement will be assessed according to the national average benchmarks of those nursing homes and facilities that participated in the first year of QIPP for these four quality measures.