07/10/2019

Ohio Awaits Budget, Nursing Homes Await Rates

Last week, The Ohio Department of Medicaid (ODM) announced that it would delay its release of new nursing facility rates until Ohio’s budget bill has passed. The announcement followed the passage of a 17-day interim budget which allowed the Conference Committee on HB 166 additional time to finish the reconciliation of the House and Senate versions of the budget bill. 

ODM had shared provider rates reflecting the 2.4% market basket increase with LeadingAge Ohio before it became clear that the budget would be delayed. While ODM has not shared the quality points by provider, it did share aggregate data on quality points received by Ohio’s nursing homes.  The statewide average rate is $202.12, a 2.95% increase from the January 1, 2019, average. The increase includes the impact of both the market basket and changes to case-mix.

ODM also shared the aggregate data on the quality points awarded. Each quality point was valued at $.42. ODM awarded no quality points for the short-stay pressure ulcer measure, which is no longer supported by CMS data. Additionally, CMS chose to award quality points to all providers for the antipsychotics measures due to data processing issues.

The detail on quality points is as follows:

Should the Senate-passed version of the state budget bill prevail, the July 1 rates will apply only through the remainder of calendar year 2019. ODM will recalculate the rates in January to include not only case-mix changes, but also a new quality incentive payment based on the nursing home’s performance on four quality metrics. 

For more details on the Senate’s quality incentive payment proposal, click here.