Nursing home administrators' opinions of pay for performance

The research presented here provides some descriptive information of nursing home pay for performance (P4P) initiatives and an examination of the opinions of nursing home administrators (NHAs) about P4P. Opinions on three common elements of P4P were examined: the incentive format, program format, and quality format. Information came from a mail survey of 2,426 NHAs. Most of the summary scores show that few NHAs gave positive responses to P4P. Very few NHAs believed that P4P would increase their revenues. NHAs were skeptical that P4P systems were for quality improvement and instead believed they were developed for purposes of cost reduction. Relatively few NHAs believed that P4P would improve quality of care. Given that we have limited experience with setting performance goals and incentive formats for NHAs, the findings presented may prove useful in modeling future P4P systems.