Health visitor and a senior woman during nursing home visit.
State, Payor Recognitions for Value-Based Contracting with Nursing Homes
States and payors are looking to identify ways to incorporate quality metrics in reimbursement or payment models — and they're looking to The Joint Commission.
National Payor Recognitions
Large national payors increasingly use Joint Commission Nursing Care Center Accreditation as a quality metric to allow network participation, contract eligibility or higher rates of reimbursement.
Joint Commission Accreditation can effectively boost reimbursement for plan participants meeting various quality measures in the following states: CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, NY, OH, VA and WI.
Curious if your payor(s) recognize Joint Commission accreditation? Contact us!
Florida – Medicaid Reimbursement for Florida’s Prospective Payment System (PPS)
Joint Commission Nursing Care Center Accreditation is a recognized “Quality Credential” helping nursing homes boost their score effectively and efficiently towards greater reimbursement.
Georgia – Medicaid Quality Improvement Initiative Program
Georgia-based nursing homes that have achieved Joint Commission accreditation can earn the maximum, 2% quality incentive adjustment under the recently updated Quality Improvement Initiative Program.
Illinois - Network Participation
Certain payors require accreditation of nursing homes for network participation in Illinois.
Massachusetts - Network Participation
Certain payors require accreditation of nursing homes for network participation in Massachusetts.
Michigan - Accreditation Requirements for Neurological Rehabilitation Facilities
Joint Commission accreditation is required for Michigan-based neurological rehabilitation clinics providing post-acute brain and spinal rehabilitation care and seeking to bill for the treatment of patients entitled to no-fault personal protection insurance benefits.
Tennessee – Points for TennCare Quality Improvement in Long Term Services and Supports (QuILTSS)
Nursing homes can earn 10 bonus points by achieving Joint Commission Nursing Care Center Accreditation, placing the facility into one of three quality tiers with escalating reimbursement.
Ohio – Quality Improvement Project for Ohio Department of Aging State Medicaid
The Ohio Department of Aging recognizes Joint Commission Nursing Care Center Accreditation for its quality initiative that requires licensed nursing homes to participate in a quality improvement project every two years.
Learn how we collaborate with states and third-party payors to recognize Joint Commission accreditation/certification for value-based performance initiatives.
Discounts on Insurance Premiums
Manchester Specialty Programs Inc. Worker's Compensation Program
Manchester Specialty Programs, Inc., offers insurance premium savings (where state regulators allow and based on each individual account) with scheduling credits on Workers’ Compensation insurance to Joint Commission accredited nursing homes.