Value Based Purchasing
Quality Improvement in Long Term Services and Supports or QuILTSS is a TennCare value-based purchasing initiative to promote the delivery of high quality Long Term Services and Supports (LTSS), focusing on the performance measures that are most important to people who receive LTSS and their families. These changes will reward providers that improve the member’s experience of care and promote a person centered care delivery model. The QuILTSS initiative will include outcome based reimbursement for services such as Nursing Facility Care, Enhanced Respiratory Care, Home and Community Based Services, Behavioral Health Crisis Prevention Intervention and Stabilization Services (SOS), as well as a program dedicated to the development of the LTSS workforce.
Nursing Facility payment will be based in part on resident’s level of need and on nursing facility performance on quality metrics set forth in the QuILTSS Quality Framework
- Nursing Facility Provider Reimbursement Rule
- QuILTSS Staff Roster
- Consistent Assignment Tracking Tool
- TennCare Memo- Price Floor After CHOW 6.12.18
- NRC Survey Distribution Tracking Tool
- QuILTSS 13 Reconsideration Form
- QuILTSS 13 Memo 9.22.20
- QuILTSS 13 Submission Memo
- Submission training at: https://www.mslc.com/tennessee/TN_ProviderTraining.aspx
Enhanced Respiratory Care services in nursing facilities are reimbursed using a system that measures quality outcomes to adjust rates based on the facility’s performance on key performance indicators.
Workforce Development is a comprehensive competency-based program for individuals paid to deliver LTSS. A program goal is for the education and training received under this program to transfer as course credit at secondary, vocational technical, trade school, community college, and 4-year institutions.