Opportunities to Advance Nursing Facility Quality of Care Through Medicare-Medicaid Integration 

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ATIWork
01/29/2024
AUTHOR – ATI Advisory

This issue brief explores the attributes of a potential Medicare-Medicaid integrated model focused on ensuring high quality and high value care for dual eligible long-stay nursing facility residents. We identify policy opportunities for CMS and states to consider to facilitate a Medicare-Medicaid model in nursing facilities, including increasing payment transparency, promoting alignment between Medicare and Medicaid quality measures, and requiring that a percentage of plan payment go towards value-based contracts with nursing facilities. Taken together, these model elements could meaningfully improve experiences for dual eligible individuals living in nursing facilities, and for their families.

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