Important updates for Texas QIPP

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Important updates to Texas QIPP

Here’s how your nursing facility may be affected by the latest QIPP changes from Texas HHS

Recently, the State of Texas made important updates to the Quality Incentive Payment Program (QIPP). If your Texas facility actively participates in QIPP, be sure to read the important details below…

What are the QIPP changes?

Recently published updates to the QIPP logic have introduced the concept of “allowed margins of decline” for each metric in QIPP component three of QIPP Year 5. The Texas Health and Human Services QIPP training materials describe these changes as follows:

  • In prior program years, a NF whose baseline was better than the national average did not need to meet improvement-over-self targets
  • Beginning in SFY2022, performing better than the national average no longer constitutes maintaining high performance
  • If the NF cannot meet improvement-over-self targets, it must perform better than the benchmark without declining on its baseline beyond the allowed margin

The allowed margins of decline for each metric are:

  • Pressure Ulcers - 0.948
  • Antipsychotic Medications - 0.091
  • Independent Mobility - 8.278
  • Urinary Tract Infections - 0.127
How does this impact Texas facilities?

The facilities most impacted will be those performing better than the national average. Consider a facility with a 10.00% performance rate for the Antipsychotic Medications measure. Under the previous methodology, this facility would meet the High Performance criteria because their performance is better than the 14.32% National Average.

Under the new methodology, however, we must calculate the minimum allowed performance based on the facility baseline. For example, if this facility had a 6.87% baseline rate, their minimum allowed performance would be equal to their baseline (6.87%) plus the allowed margin of decline (0.091%).

Their new High Performance target is 6.961% instead of the National Average. Therefore, this facility would not be considered as having met the High Performance target in QIPP Year 5.

How is SimpleLTC accommodating these QIPP changes?

SimpleLTC has already updated our SimpleAnalyzer™ QIPP Module to ensure our data accurately shows whether a facility has met its QIPP targets. You can feel confident that the data you now see will clearly indicate whether your facility has met its targets.

We're now further improving the QIPP dashboard to show actual new QIPP targets, so you'll be able to clearly understand the variance and what changes are needed to meet your targets. We'll roll out those changes as soon as possible.

We understand the difficult timing of these changes given how close we are to the end of the year. We're working hard at SimpleLTC to make our QIPP dashboard even more helpful in understanding your current QIPP status.

Questions?

If you have questions about the latest QIPP changes or how your Texas QIPP data appears in Simple analyzer™, please reach out to our Support Team for help.

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