Incentivizing Nursing Home Quality and Physician Performance

Nursing homes (NHs) are under increasing pressure to accurately gauge and improve the quality of care they provide to their residents. Higher patient acuity, demand from consumers and policy-makers, and media reports of inadequate care are providing the impetus for change. In response to these pressures, researchers are devising more appropriate indicators of quality,¹ states are creating innovative financial models to reward the delivery of higher quality care, and the American Medical Directors Association (AMDA) is developing strategies to better gauge the performance of NH physicians and medical directors. The interplay of these factors not only has provided new opportunities to impact approaches to quality measurement in the NH but also has rejuvenated interest in measuring the impact of physician performance on NH quality. In this article, we highlight the efforts of one state that is in process of implementing an incentivized model for high-quality care that includes physician certification in the model. We end by offering potential solutions to enhancing physician involvement in NH affairs and weaving physician performance into these evolving models.