We’re announcing the Michigan Skilled Nursing Facility Pay-for-Performance Program

On Jan. 1, 2016, Blue Cross Blue Shield of Michigan will launch its Skilled Nursing Facility Pay-for-Performance Program. The program will give incentive rewards to Michigan freestanding and hospital-based SNF providers that improve quality and meet health information exchange expectations.

The goal of the SNF P4P is to:

• Enhance the population-based model of health
• Promote a team-based approach
• Engage a strong commitment to the care continuum
• Help ensure that a patient’s caregivers receive timely notification of an admission, discharge, transfer or emergency room visit
• Improve coordination of care and outcomes
• Reduce the likelihood of an unplanned readmission

The Michigan Health Information Network, or MiHIN, has established a statewide notification service to help address the need for more timely information and:

• Give practitioners daily, all-payer ADT and ER census reports for their patients.
• Help practitioners better prepare for and support their patients when they’re discharged from an acute care hospital, SNF or ER to the home or another care setting.
• Improve the transition process.
• Help ensure a better health outcome for the patient.
• Reduce the likelihood of an unplanned readmission.

Program details and reward
In the program’s first year, we’ll recognize SNFs that are successful in:

• Electronically transmitting and receiving all-patient and all-payer ADT data into the statewide notification service administered by MiHIN daily
• Submitting a list of patients in order to electronically receive post-discharge notifications for the purpose of improving transitions of care

Providers achieving the program expectations and deadlines will be eligible to receive an additional 1 percent reward for either six or 12 months following the incentive’s effective date.

SNFs not meeting the SNF P4P program requirements or choosing not to participate will forfeit the incentive opportunity.

Important dates

Additional information

• Future program years may focus on enhanced health information exchange and quality measure reporting and performance.
• Program guides will be published and distributed to the SNF community in December, prior to the beginning of the program year.
• SNF performance will be evaluated twice per program year — once in February and again in August — with the corresponding incentive uplift applied in April and October 2016, respectively.

If you have questions, contact your provider consultant.

**Skilled nursing facility providers must meet Blue Cross’ participating provider criteria at least six months before the performance deadline to be eligible for P4P incentives.