Minnesota's provider-initiated approach yields care quality gains at participating nursing homes

Greg Arling, Valerie Cooke, Teresa Lewis, Anthony Perkins, David C. Grabowski, Kathleen Abrahamson

Research output: Contribution to journalArticle

15 Scopus citations


Minnesota's Performance-Based Incentive Payment Program uses a collaborative, provider-initiated approach to nursing home quality improvement: up-front funding of evidence-based projects selected and designed by participating facilities, with accountable performance targets. During the first 4 rounds of funding (2007-10), 66 projects were launched at 174 facilities. Using a composite quality measure representing multiple dimensions of clinical care, we found that facilities participating during this period exhibited significantly greater gains than did nonparticipating facilities, in both targeted areas and overall quality, and maintained their quality advantage after project completion. Participating and nonparticipating facilities were similar at baseline with respect to quality scores and improvement trends, as well as acuityadjusted payment, operating costs, and nurse staffing. Although selfselection precludes firm conclusions regarding the program's impacts, early findings indicate that the program shows promise for incentivizing nursing home quality improvement, both in facility-identified areas of concern and overall.

Original languageEnglish (US)
Pages (from-to)1631-1638
Number of pages8
JournalHealth Affairs
Issue number9
StatePublished - Oct 16 2013

ASJC Scopus subject areas

  • Health Policy

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