AdministrativeMedicaidJune 14, 2024

Skilled Nursing Facility Workforce and Quality Incentive Program

The Skilled Nursing Facility (SNF) Workforce & Quality Incentive Program (WQIP) incentivizes facilities to improve quality of care, advance equity in healthcare outcomes, and invest in workforce. WQIP functions as a directed payment program in Medi-Cal delivery system for eligible network providers. WQIP is authorized by Welfare & Institutions Code Section 14126.024 (added by Assembly Bill (AB)186 (Chapter 46, Statutes of 2022)) for dates of service January 1, 2023, through December 31, 2026. WQIP succeeds the former SNF Quality and Accountability Supplemental Payment (QASP) program.

If you have WQIP program-related questions or concerns, please reach out to WQIP support staff at SNFWQIP@dhcs.ca.gov.

DHCS will issue guidance to Anthem later in 2024 to make final payments for CY 2023 based on SNF WQIP-Eligible Days reported to DHCS's data warehouse by June 30, 2024, and final scores for all SNF WQIP metrics including acuity-adjusted staffing hour metrics, staff turnover metric, MDS clinical metrics, claims based clinical metrics, Medi-Cal disproportionate share metric, and MDS racial and ethnic data completeness metric.

At this link WQIP Qualifying List is a document with NPIs that DHCS has on file for facilities as of May 7, 2024.

If your current or previous NPI is not listed on the WQIP Qualifying List, please email the DHCS SNFWQIP inbox at SNFWQIP@dhcs.ca.gov and complete the form provided in the automatic reply. Note that if an incorrect NPI is listed along with all correct NPIs, there is no reason to reach out to DHCS via email. Please note, only submit one form per facility.

The performance period ranges covered in the Quarterly Performance Report #1 below:

  • Acuity Adjusted Staffing Metrics: April 2023-June 2023
  • Staffing Turnover: October 2023 refresh rates:
    • With lookback and look-forward quarters: January 2022 to June 2023
    • Without lookback and look-forward quarters: April 2022 to March 2023
  • MDS Metrics: July 2022 to June 2023
  • Medi-Cal Disproportionate Share: January 2023 to June 2023
  • Race/Ethnicity Data Completeness: January 2023 to September 2023

If you have any questions, please reach out to AnthemLiaison@anthem.com.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Blue Cross of California Partnership Plan, Inc. are independent licensees of the Blue Cross Association. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

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PUBLICATIONS: July 2024 Provider Newsletter