Workgroup Approves Medicaid Price-Based Payment Transition

Earlier today, the Department of Medical Assistance Services (DMAS) Nursing Facility Medicaid Payment Workgroup voted to approve the transition from Virginia’s cost-based payment system to a price-based methodology.  Capping off over two years of analysis and development, members of the workgroup voted in favor of specific language that would begin to implement a fully prospective price-based payment methodology starting July 1, 2014.  The DMAS workgroup is comprised of representatives of all three associations representing nursing facilities – VHCA, the Virginia Hospital and Healthcare Association and the Virginia Association of Nonprofit Homes for the Aging.  The overall move to price-based payment is viewed as a key factor in transitioning successfully to managed care under Commonwealth Coordinated Care – Virginia’s dual eligible financial alignment demonstration.

The language approved by the workgroup will require the approval of the General Assembly.  VHCA is working to finalize the budget amendment required for consideration by legislators.  We will provide additional information to our members early next week.