Long-term care stakeholders are closely monitoring a new Medicare payment proposal that is tied to quality of care measures for hospitals.

The Centers for Medicare & Medicaid Services plan would trim base payments by up to 5%, but hospitals could earn more with good scores on quality of care measures, officials said. Congress would have to pass legislation to enact any such policy change.

Acting CMS Administrator Kerry Weems said the Medicare Hospital Value-Based Purchasing (VBP) Program is part of his agency’s “ongoing initiative to transform Medicare from a payer of bills to a prudent purchaser” of healthcare for its beneficiaries. CMS and other government sources pay for approximately 75% of all nursing home care in the United States. Some observers believe nursing home operators would be a logical target for an aggressive “pay for performance” scheme.