The Department of Health and Human Services has released final details on how it will pay out $2 billion in COVID-19 relief funding through its incentive-based payment program.
Initial details for the program indicated that HHS would use two outcomes to measure a providers’ performance to determine whether they qualify for the funding: how well they keep down both coronavirus infection rates and mortality.
More specifically, HHS explained that providers’ non-admission COVID-19 infection rate must be below the rate of infection in their county. Additionally, a nursing home’s rate of COVID-19 deaths among residents who acquired the virus within the nursing home must be below a nationally established performance threshold for mortality among nursing home residents infected with COVID-19.
“Failure to pass this gateway disqualifies a nursing home from receiving any incentive payment for that month,” LeadingAge explained in a blog post Friday.
Nursing homes eligible for the funding will then have their performance based on the infection and mortality measures. The infection measure accounts for 80% of the incentive payment dollars and will be calculated by taking the total number of non-admission COVID-19 infections divided by their total number of resident-weeks as reported in National Healthcare Safety Network, the Centers for Disease Control and Prevention’s tracking system that is receiving COVID-19 data from nursing homes. It will also be compared to the county infection rate.
The mortality measure will account for 20% of the incentive payment and will be assessed for facilities who have at least one non-admission COVID-19 infection. LeadingAge explained the measure will be risk-adjusted with relevant health and demographic data.
“It will also use NHSN data including: total number of COVID deaths resulting from in-facility infections [and] total number of non-admission infections,” the group explained
“This will include infected residents from the performance period as well as several weeks prior to the performance period. HHS will reach out to nursing homes with at least one COVID death during the performance period and whose residents represent a mix of infection sources (e.g. nursing home acquired and admitted with COVID) to ascertain how many of the residents who died acquired COVID while in the nursing home,” it added.