Nursing Home Providers Advocate for More Funding Accountability Through New Incentivized Program

PHCA develops ecwip program to enhance care and improve state funding

Harrisburg, PA (January 29, 2024) — The Pennsylvania Health Care Association (PHCA) is asking Governor Josh Shapiro and the state legislature to adopt and fund a quality incentive program designed to enhance care and reward high-performing long-term care providers. The Enhancing Care With Incentivized Payments program –– or ecwip –– evaluates current data to measure key quality outcomes of resident care at each nursing facility. If providers meet or exceed the metric goals, they will be “equipped” with additional funds to further improve care outcomes.

“Nursing home providers in PHCA membership and across the commonwealth are grappling with insufficient reimbursement rates and rising costs, while trying to remain focused on delivering the best possible care to our most vulnerable residents,” said Zach Shamberg, president and CEO of the Pennsylvania Health Care Association. “Recognizing this, we developed ecwip to support providers who are enhancing resident care by rewarding them with additional funds that can be reinvested into their mission of caring for others. If providers don’t meet the grade, they don’t receive additional funding –– it’s that simple. This adds a whole new layer of accountability for state funding that should be allocated for the high-quality care of our loved ones and neighbors.”

PHCA is advocating in this year’s state budget for the adoption of ecwip and the allocation of $100 million from the state to fund the program. This innovative funding solution will further motivate providers to elevate standards of care by incentivizing performance results. Providers that do not maintain or elevate their resident care outcomes will not receive additional funding, leaving more funds to reward providers that are meeting the new goals.

“This is not a typical state budget request for more funding with no strings attached. This is not an ask for a handout,” Shamberg said. “This is an essential industry joining together and saying, ‘make a commitment to invest in high-quality senior care and reward us when we earn it.’ Why wouldn’t state leaders want to see more accountability for state dollars?”

PHCA’s ecwip program focuses on four key quality measures:

Percentage of long-stay residents experiencing one or more falls with major injury
Percentage of long-stay residents with pressure ulcers
Percentage of long-stay residents with worsening activities of daily living (ADL)
Total nursing staff turnover rate

These four measures were chosen because each focuses on the well-being of residents and the efficiency of providers to reduce systematic health care costs. ecwip also promotes healthy occupancy levels at nursing homes by encouraging providers to innovate resident environments that will improve quality of life initiatives, such as transitioning more toward single occupancy rooms to further improve infection controls and operational efficiency.

ecwip favorably incentivizes providers that disproportionately care for more Medicaid-reliant residents, or low-income residents. High-Medicaid providers are likely to have less revenue to invest in resident care because Pennsylvania’s Medicaid reimbursement rate falls short of the actual cost of care.

Twenty-four other states have already implemented similar programs to expand funding support and enhance care. Ohio launched an incentive program in 2020 that also focused on four quality metrics. The statewide average for those four measures improved by an average of 34%. Ohio is now ranked within the top four states in three of the four quality measures.

“We must all step up to enhance care and meet the growing demand of caring for our aging population,” Shamberg added. “And that includes funding this critical need.”

PHCA will continue to work with the Shapiro administration and members of the General Assembly on the adoption of ecwip.

To learn more about PHCA’s ecwip program, click here.

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