Quality Incentive Payment Program for Nursing Homes

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 2025 (Y8) Metrics and Requirements

CMS approved QIPP for Year 8 on Aug. 15, 2024, setting the final pool size for the program year at $1.75 billion.

QIPP SFY 2025 does not require facilities to submit data to HHSC for program quality measures. All quarterly performance data will come directly from CMS public use files (PUFs) available at the Provider Data Catalog.

SFY 2026 (Y9) Metrics and Requirements

CMS approved QIPP for Year 9 on Aug. 15, 2024.

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).

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