The LTSS Center toolkit shows policymakers how to use Medicaid funds to promote person-centered care in nursing homes.
A new toolkit from the LeadingAge LTSS Center @UMass Boston outlines steps that policymakers at the state level can take to implement a pay-for-performance (P4P) program that uses Medicaid funds to promote person-centered care in nursing homes.
Using Medicaid Funds to Promote Person-Centered Care in Nursing Homes: A Toolkit for Policymakers focuses on lessons learned from implementation of the Promoting Excellent Alternatives in Kansas Nursing Homes (PEAK 2.0), a program that helps Kansas nursing homes implement person-centered care.
LTSS Center researchers found that residents of PEAK 2.0 nursing homes that adopted person-centered care comprehensively reported higher levels of satisfaction and better clinical outcomes, compared to residents of non-PEAK 2.0 homes.
The Toolkit for Policymakers offers guidance on how to establish a P4P program like PEAK 2.0 at the state level. It describes the PEAK 2.0 program in detail and outlines how nursing homes move through the program’s 5 levels. It also offers key lessons that can help state policymakers launch and find sustainable financial support for a successful P4P program that promotes person-centered care.
PERSON-CENTERED CARE
Person-centered care aims to transform the regimented, institutional nursing home environment by infusing it with principles and practices that encourage:
- Resident direction of care and activities.
- Staff empowerment.
- Collaborative and decentralized decision-making.
- A home-like living environment.
- The breakdown of nursing home spaces into small “households.”
Progress toward comprehensive adoption of person-centered care has been impeded by several factors, according to the toolkit. Most notably, nursing home operators tend to over-report the extent of their person-centered care adoption, often because they don’t fully understand everything that person-centered care entails.
WHAT SETS PEAK 2.0 APART?
Several features set the Kansas PEAK 2.0 program apart from other P4P programs, according to the toolkit. PEAK 2.0 has:
- A strong educational component to train nursing home staff members about person-centered care practices.
- A clear pathway to success that spells out distinct steps to implementation of person-centered care and provides ample support to help nursing homes complete those steps.
- An escalating financial incentive that encourages participating nursing homes to adopt person-centered care comprehensively. Those incentives currently offer $3 per Medicaid resident per day to nursing homes at the highest levels of the PEAK 2.0 program.
- Rigorous evaluation to ensure that nursing homes progress toward comprehensive adoption of person-centered care in a timely manner and sustain their practices.
Because PEAK 2.0 is funded by Medicaid, it is relatively inexpensive to administer, compared to other P4P programs for nursing homes.
“The Kansas PEAK 2.0 program can serve as a model for other states,” concludes the toolkit. “Based on the research highlighted in this toolkit, policymakers in other states should seriously consider developing a similar pay-for-performance mechanism to improve nursing home quality through the comprehensive adoption of person-centered care.”