Value-Based Purchasing is Here.
Are You Ready?
As the role of valued-based contracting increases in health care, states, insurers and payors are looking to identify ways to incorporate quality metrics in reimbursement or payment models - and they're looking to The Joint Commission.
Here are just some examples where Joint Commission Nursing Care Center Accreditation is used as a quality metric to allow payment approval, network participation, contract or licensure eligibility and higher rates of reimbursement for nursing homes:
- Value Scorecard - Certain payors/insurers recognize Joint Commission accreditation towards a center’s value score and offer higher rates of reimbursement when a threshold score is met.
- State Recognitions - State regulatory agencies leverage Joint Commission accreditation for defining quality.
- State of Florida uses quality metrics to increase reimbursement to high-performing facilities. The Joint Commission’s Nursing Care Center Accreditation is one of the credentials recognized and awards points to centers achieving this distinction.
- State of Ohio accepts Joint Commission accreditation as a quality improvement project for meeting its nursing home quality initiative.
- State of Tennessee awards nursing facilities 10 bonus points for being accredited by The Joint Commission, positioning these centers for higher rates of reimbursement.
- Network Participation - BlueCross BlueShield of Illinois requires Joint Commission accreditation for extended care facilities that wish to participate contractually as an HMO provider in the network.
- Alignment with Other Quality Metrics - Joint Commission accreditation is proven to help nursing homes enhance their quality outcomes. A study published in JAMDA shows Joint Commission-accredited nursing homes outperform non-accredited nursing homes on 8 of 13 key quality measures.
