Medicaid Quality Incentive

Hospitals in Washington State have the opportunity to earn a one percent incentive payment under the Medicaid Quality Incentive program. The MQI program is a partnership between the Health Care Authority (HCA) and Washington State Hospital Association (WSHA).

The Medicaid Quality Incentive was established in 2010 through WA legislation to support the Hospital Safety Net Assessment. All Prospective Payment System (PPS) hospitals in WA state may earn up to a 1% increase in inpatient Medicaid payments if they meet specific quality and financial reporting requirements. Participation in the program is over a 6-month period starting from July through December.  MQI incentive payments are funded by quarterly assessments paid to the state by hospitals and federal matching funds.

These are program requirements to earn the incentive.

• Timely reporting of financial data
• Submission of quality measures as defined in the MQI Guidelines
• DOH and WSHA provide financial and quality performance to the HCA. The HCA makes the final determination of who receives the payment.
• HCA Hospital Reimbursement
• 2023-2025 MQI Program Key Dates

Step 1: Check Your Eligibility

• Not all hospitals in WA are eligible to earn a financial incentive. Critical access hospitals (CAH) may report quality measures, but they are not eligible to receive a financial incentive through the MQI program because they do not participate in the Safety Net Assessment program.
• Not all measures are relevant to all hospitals. Select a grid below, find your hospital and review which MQI measures are eligible towards your incentive.

• Eligibility grid
• Critical Assess Hospitals (CAHs) do not participate in the Safety Net Assessment and therefore are not eligible for the financial incentive. CAH Hospitals that meet the criteria for the incentive will be recognized through the CAH Achievement of Quality Excellence. Contact Megan Herman (MeganH@wsha.org) for any questions.
• Non CAH
• CAHs

Step 2: Review the Measures

For the 2024 MQI measures list please reference the documents below.

Review the specifications for each measure that your hospitals is eligible to report on.

• Climate Change: Monitoring of Greenhouse Gas Emissions/ [measure details]
  
• Opioid Harm Prevention: Naloxone Distribution/ [measure details]
  • SUD Needs Assessment: Qualtrics Survey Link [Please note: Qualtrics enables users to save their progress and return to it using a “bookmark” feature. Additionally, it allows for generating a PDF at the end]
  • SUD Needs Assessment: [PDF]
    
• (New) Equity: Patient Demographics/ [measure details]
  • DASH- Inpatient & Observation Demographic dashboard: After signing in users should navigate to: DASH > Quality Improvement > (scroll down) and click on the Inpatient & Observation Demographic dashboard
    
• Falls: Falls Prevention and Harm Reduction/ [measure details]
  • QBS-Falls-Form-2023 v11_16 Updated 11_20_2023
  • QBS Falls Form Upload (instructions)
  • Falls Locations Glossary Final
  • DASH– Falls dashboard: After signing in users should navigate to: DASH > Quality Improvement > (scroll down) and click on the Falls dashboard
    
• (New) Safe Deliveries Roadmap: perinatal Mental Health/ [measure details]
  • Perinatal Gap and Needs Assessment: Qualtrics Survey Link [Please note: Qualtrics enables users to save their progress and return to it using a “bookmark” feature. Additionally, it allows for generating a PDF at the end]
  • Perinatal Gap and Needs Assessment: [PDF]
  • Please note: The deadline for point allocation for the Perinatal Gap and Needs Assessment passed on August 31, 2024, but since this measure is part of a statewide practice assessment and will be used to inform programming, we would greatly appreciate and encourage hospitals to submit it.
    
• (New) Sepsis: Sepsis and Diagnostic excellence/ [measure details]
  • QBS Sepsis Form -2024 v1
  • DASH- Sepsis dashboard: After signing in users should navigate to: DASH > Quality Improvement > (scroll down) and click on the Sepsis dashboard
  • Hospital Sepsis Program Core Elements Assessment Tool: Qualtrics Survey Link [Please note: Qualtrics enables users to save their progress and return to it using a “bookmark” feature. Additionally, it allows for generating a PDF at the end]
  • Hospital Sepsis Program Core Elements Assessment Tool: [PDF]
  • Please note: The deadline for point allocation for the Needs Assessment passed on September 1, 2024, but since this measure is part of a statewide practice assessment and will be used to inform programming, we would greatly appreciate and encourage hospitals to submit the CDC Core Element Program Needs Assessment.
    
• Workforce Safety: Workplace Violence (WPV)/ [measure details]
  
• Download the full 2024 MQI Measure Set [measure details]  
• 2024 MQI Measure Thresholds [thresholds details]

Step 3: Enter Data & Monitor Progress

The MQI 2024 data collection period is from July 1^st through December 31^st. See reporting details in the measure specifications (Step 2).  The final reporting deadline is 30 days after the close of the performance period or by January 31, 2025.

*WSHA encourages hospitals to submit data early for an opportunity to be pre-reviewed by Clinical Excellence staff. Data cannot be corrected after Jan 31st, 2025.

• Quality Benchmarking System (QBS) This is a secure data entry system developed for WSHA where hospitals can directly enter data, upload files and documents to fulfill most MQI measure requirements. You must be provided access to QBS to submit data and upload supporting documentation for your hospital.
  • Request access to QBS
    
• Data Analytics Service Hub (DASH) This is a secure data visualization platform developed by WSHA to display hospital progress towards meeting MQI performance measures. You must be provided access to DASH to view  your hospital MQI Report Card.
  • Request access to DASH
    
  • Final determination of your hospitals performance and incentive achievement is made by the Health Care Authority and notification will be made directly to your leadership.

MQI Webinars

The WSHA Clinical Excellence team supports all MQI focus areas with tools, resources, webinars and coaching. Keep an eye out for upcoming events and review the links below to recordings/registration by measure topic.
For the 2024 MQI related webinar list please reference the link/s below.

• Topics (specific to the measure) I Webinar recordings /webinar slides I Date I Link
• WSHA Analytics Office Hour I Slides I April 16, 2024
  To obtain the Zoom Recording of the April Office Hour, please send an email to SerenaC@wsha.org
• WSHA Analytics Office Hour I Recording I May 14, 2024
• MQI Kick-off I Slides I Recording I June 3, 2024
• MQI Measure Training I Recording I June 11, 2024
• MQI Measure Training I Recording I Passcode: 4#5BcAJ$ I July 9, 2024
• WSHA Analytics Office Hour I Recording I August 13, 2024
• WSHA Analytics Office Hour I Recording Part 1 & Recording Part 2 I September 10, 2024
  Due to the sensitivity of the data and the review conducted on DASH during the Analytics Office Hour on September 10th, the recording has been divided into two sections.
• WSHA Analytics Office Hour I Recording I October 8, 2024
• WSHA Analytics Office Hour I REGISTER HERE I Second Tuesday of each month I 9-10am PDT
  
• Safety & Quality Program Overview Webinar I June 3, 2024 I To obtain the Zoom Recording of the S&Q Program Overview Webinar, please send an email to MeganH@wsha.org