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WQIP Program Policies and Letters - 2023 to Current
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2025 Program Policies and Letters
SNF WQIP PL 24-004 SNF WQIP MDS Measures for PY3 (2025)
| PY3 (2025)
| WQIP PL 24-004 SNF WQIP MDS Measures for PY3 (2025) outlines the MDS clinical measures for the SNF WQIP for PY 3 (2025). The MDS clinical measures that are being used in PY 3 are listed in the table below. Please note, DHCS will provide PY 3 benchmarks in December 2024 for the MDS measures listed. DHCS is providing these measures now as the measurement period, as in all prior PYs, is six months offset in advance of the calendar year. For PY 3, the MDS measurement period is July 1, 2024 to June 30, 2025.
| 8/23/2024
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SNF WQIP PL 24-008 SNF WQIP Disproportionate Share Metric PY3 (2025)
| PY3 (2025)
| This policy letter (PL) provides an update to the data source for the Medi-Cal Disproportionate Share metric for the skilled nursing facility (SNF) Workforce and Quality Incentive Program (WQIP). Beginning in PY 3 (2025), this metric will utilize the Minimum Data Set (MDS) assessment data to determine the number of Medi-Cal days and the daily number of patients in place of the Medi-Cal Bed Day (MCBD) data and the Payroll Based Journal (PBJ) data, respectively.
| 11/13/2024
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SNF WQIP PL 24-010 Floor for Improvement Points in PY3 2025
| PY3 (2025)
| DHCS will implement an achievement floor for facilities to be eligible to earn improvement points for MDS measures to minimize the chance that a facility receives an incentive under the Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP) and a sanction under the Accountability Sanctions Program (ASP) on the same Minimum Data Set (MDS) measure.
| 1/30/2025
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SNF WQIP PL 24-011 Increases the Amount of Funding Tied to Workforce Metrics Domain for PY 3 (CY 2025)
| PY3 (2025)
| DHCS will increase the funding allocated to the workforce metrics to 55 percent for PY 2025. The additional 5 percentage points are derived from the removal of the MDS Racial and Ethnic Data Completeness Measurement Area and a 2 percentage point reduction in the allocation tied to the Clinical Metrics Domain.
| 1/30/2025
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2024 Program Policies and Letters
SNF WQIP PY2 (2024) Updates Letter
| PY2 (2024)
| The SNF WQIP PY2 (2024) Updates Letter provides a list of changes to SNF WQIP PY2 (2024). | 1/31/2024
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SNF WQIP PL 24-006 Weight Loss Measure for PY2 (2024)
| PY2 (2024)
| This policy letter (PL) outlines the updated and shortened measurement period for Percent of Residents Who Lose Too Much Weight, Long Stay measure. Performance during the shorter measurement period will continue to have the same weight in the overall WQIP score.
| 9/23/2024
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SNF WQIP PL 25-001 Second SNF WQIP Weight Loss Measure for PY2 (2024)
SUPERSEDES PL 24-006
| PY2 (2024)
| To prevent penalizing facilities due to a shorter measurement period, DHCS will adjust how points are awarded for the LTMW measure. Facilities will receive the higher score of the following two options: one based on the shortened LTMW measurement period (April 1, 2024 – June 30, 2024) and the other based on the full PY2 measurement period (July 1, 2023 – June 30, 2024). For example, if a facility’s original score for the LTMW measure for the full PY2 measurement period was 6 points, but their score for the shortened LTMW measurement period was 2 points, they would receive the higher of the two scores, which would be 6 points.
| 1/30/2025
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2023 Program Policies and Letters
SNF WQIP PL 24-001 SNF WQIP Provisional Guidance on SNF WQIP Payment Process
| PY1 (20203)
| This Policy Letter (PL) outlines provisional guidance for the Skilled Nursing Facility (SNF) Workforce & Quality Incentive Program (WQIP) to assist SNFs and Managed Care Plans (MCPs) with planning the reconciliation and payment processes for the Calendar Year (CY) 2023 final payments. This guidance will be incorporated into a forthcoming All Plan Letter (APL) directed to MCPs.
| 7/1/2024
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SNF WQIP PL 24-002 MDS Data Completeness Updated Methodology and Clarification
| PY1 (2023)
| WQIP PL 24-002 MDS Data Completeness Updated Methodology and Clarification” outlines updated Minimum Data Set (MDS) Data Completeness methodology and technical clarification for the SNF WQIP. DHCS updated the MDS Data Completeness Metric methodology using 150-day exclusion approach. This change is effective retroactively for PY 1 of SNF WQIP and is based on stakeholder feedback. The Technical Program Guide for PY 2 (2024) will include similar methodology. Please review the attached PL for additional information and background.
| 8/23/2024
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SNF WQIP PL 24-003 Claims-Based Clinical Metrics Update
| PY1 (2023)
| Due to the lack of data or biased rates from multiple managed care plans (MCPs), the Department of Healthcare Services (DHCS) and its contractor, Health Services Advisory Group (HSAG) will calculate facility-specific rates for the claims-based clinical metrics for SNF WQIP for PY 1 (2023). This change is expected to delay the CY2023 WQIP final payments to SNFs.
| 9/5/2024
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SNF WQIP PL 24-005 PY 1 (2023) Technical Program Guide Update
| PY1 (2023)
| This Policy Letter (PL) outlines correction to the PY 1 (2023) Technical Program Guide for the Skilled Nursing Facility (SNF) Workforce & Quality Incentive Program (WQIP).
| 9/5/2024
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SNF WQIP PL 24-009 Second Claims Based Clinical Metrics Update
SUPERSEDES PL 24-003
| PY1 (2023)
| Following communication on the data issue and that Health Services Advisory Group, Inc. (HSAG) was to calculate facility-specific performance on these measures (reference WQIP-PL 24-003 Claims-Based Clinical Metrics Update), DHCS and HSAG were still unable to calculate facility-specific rates for SNF WQIP for PY 1 (2023) due to further data issues and timeline constraints. DHCS and HSAG will reallocate the percent of the total score for the Claims-Based Clinical Metrics Measurement Area to the Minimum Data Set (MDS) Clinical Metric Measurement Area or the Workforce Metrics Domain. This change is not expected to further delay the CY 2023 WQIP final payments to SNFs. This PL SNF WQIP PL 24-009 Claims-Based Clinical Metrics Update Version 2.0 supersedes WQIP-PL 24-003 Claims-Based Clinical Metrics Update, which is published to the SNF WQIP webpage.
| 12/18/2024
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Last modified date:
4/2/2025 2:01 PM
