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The Quality Incentive Payment Program (QIPP) is a state directed payment program (DPP) designed to help nursing facilities achieve transformation in care quality through innovation. QIPP was first implemented on Sept. 1, 2017.
This page includes an overview of QIPP and current and proposed requirements and metrics. For rules, regulations and previous years’ requirements and metrics, visit QIPP Overview and History. For reporting and quality improvement resources, visit QIPP Resources.
For information on enrollment, eligibility and payment, visit the QIPP Provider Finance Department.
Background
Two classes of Texas nursing facility (providers) serving residents enrolled in STAR+PLUS Medicaid are eligible to participate:
- Non-state governmental owned entities (NSGO).
- Privately-owned facilities that have a percentage of Medicaid NF days of service that is greater than or equal to 65%.
SFY 2024 (Y7) Metrics and Requirements
- QIPP SFY 2024 Quality Metrics and Associated Performance Requirements (PDF) (2/6/2024)
- Component One PIP Reporting Template (Excel): This document will be used to fulfill the condition of participation requirements. Facilities must conduct monthly activities and report progress updates twice a year (Dec. 6, 2023, and Sept. 6, 2024).
- Component Two PIP Reporting Template (Excel): This document will be used to fulfill the SFY 2023 condition of participation requirements for the third metric in Component Two. Facilities must report progress updates twice a year (Dec. 6, 2023, and Sept. 6, 2024).
- Component Two: RN Staffing hours: Facilities must submit information through the QIPP Data Submission Portal each month.
- Component Three: NFs do not have to report MDS data or results to HHSC for QIPP. NFs Report MDS Assessment Data to CMS, per federal requirements.
- Component Four: Nursing Facilities must collect audit data for each month within the program year and report cumulative summaries to HHSC twice a year (Dec. 29, 2023, and June 28, 2024).
- Hand Hygiene Observational Audit Tracking Tool (Excel): This pre-programmed Excel workbook has been published by the Agency for Healthcare Research and Quality (AHRQ) and is used in conjunction with the Hand Hygiene Observational Audit Tracking Tool User Guide (PDF).
- Personal Protective Equipment (PPE) COVID-19 Observational Audit Tracking Tool (Excel): This pre-programmed Excel workbook has been published by the AHRQ and is best used in conjunction with Personal Protective Equipment (PPE) COVID-19 Observational Audit Tracking Tool User Guide (PDF).
- Antibiogram: Nursing Facilities are not required to use a specific template for reporting their antibiogram. AHRQ has offered a template.
- Infection Control and Antibiotic Stewardship policies: Nursing Facilities are not required to use a specific template. Nursing facilities can utilize resources published by AHRQ, CDC, and other agencies to tailor development and implementation of evidence-based policies and practices.
Proposed SFY 2025 (Y8) Measures and Associated Reporting Requirements
- Proposed SFY 2025 (YR8) Quality Metrics (PDF) (8/7/2024)
- Webinar recording: Getting Ready for QIPP SFY 2025 (Y8) (7/23/2024)
- Webinar slide deck: Getting Ready for QIPP SFY 2025 (Y8) (7/23/2024)
The revised quality metrics defined above are subject to change. They have been submitted to CMS for annual program review and approval but are not final. Final quality metrics and performance requirements will be announced via GovDelivery alert, following CMS' approval.
Rules
QIPP is governed by the following Texas Administrative Code (TAC) rules: 353.1301, 353.1302, 353.1303 and 353.1304.
Federal regulatory authority governing QIPP as a state-directed payment program is contained in 42 CFR §438.6(c).
Contact Information
- If you have questions, email QIPP.
- Subscribe to get GovDelivery updates.