Linking Payment to Long-Term Care Quality: Can Direct Care Staffing Measures Build the Foundation?

To improve long-term care quality, state and federal policymakers are experimenting with positive incentives to reward providers who can demonstrate better quality. Incentive payment systems are part of a broader trend in the health care field, referred to as “pay-for-performance” and may consist of either financial payments or non-financial recognition. This paper describes the challenges involved in designing effective quality incentive payment systems in the long-term care sector.