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  • NJ A4069
  • Establishes payment incentive program for home health agencies and health care service firms.
Introduced
(9/15/2016)
In Committee
(9/15/2016)
Crossed OverPassedSignedDead/Failed/Vetoed
2016-2017 Regular Session
This bill will require the Division of Medical Assistance and Health Services in the Department of Human Services to establish a pay-for-performance program, which will be mandatory for licensed home health agencies and registered health care service firms providing services to NJ FamilyCare recipients enrolled in a Fully Integrated Dual Eligible Special Needs Plan. The division will establish a system to measure improved performance outcomes for Fully Integrated Dual Eligible Special Needs Plan beneficiaries, and rank participating home health agencies and health care service firms as determined by how well the agencies or firms meet seven "Outcome and Assessment Information Set" measures. The measures include: 1) Incidence of Acute Care Hospitalization; 2) Incidence of Any Emergent Care; 3) Improvement in Bathing; 4) Improvement in Ambulation or Locomotion; 5) Improvement in Transferring; 6) Improvement in Management of Oral Medications; and 7) Improvement in Status of Surgical Wounds. The division will rank participating home health agencies and health care service firms by each Outcome and Assessment Information Set measure, in terms of absolute performance level and percentage improvement in performance relative to the base year. Base year is defined as the 12 month period before the start of the program. The requires the Department of Human Services to appropriate $5 million for distribution to home health agencies and health care service firms for the pay-for-performance program. Furthermore, the bill instructs that the pay-for-performance appropriations are distributed as follows: 75 percent of the appropriation will be distributed to those home health agencies and health care service firms which are ranked by the division in the top 20 percent for absolute performance level; and 25 percent of the appropriation will be distributed to those home health agencies and health care service firms which are ranked in the top 20 percent for improvement in performance relative to base year. The bill also provides for an evaluation of the program and an annual report to be submitted to the Legislature on the program no later than three years after the start of the program.
Health and Senior Services
Introduced, Referred to Assembly Health and Senior Services Committee  (on 9/15/2016)
 
 
Date Chamber Action Description
9/15/2016 A Introduced, Referred to Assembly Health and Senior Services Committee
Date Motion Yea Nay Other
None specified