Pay for Performance (P4P) Incentive Payments | Department of Human Services | Commonwealth of Pennsylvania
Source: https://www.pa.gov/agencies/dhs/resources/for-providers/pay-for-performance
Archived: 2026-04-23 17:09
Pay for Performance (P4P) Incentive Payments | Department of Human Services | Commonwealth of Pennsylvania
Pay for Performance (P4P) Incentive Payments
Pay for performance (PRP) incentive payments are be made to qualifying county nursing facilities each quarter of the fiscal year based on qualifying criteria.
A county nursing facility will qualify for the P4P incentive payment if both of the following criteria are met:
The facility is a county nursing facility at the time of payment.
The facility's Medicaid case mix index (CMI) for the picture date is higher than its facility Medicaid CMI for the previous picture date.
P4P Payment Period
Picture Date
Pervious Picture Date
Quarter 1: July 1-Sept. 30
August 1
May 1
Quarter 2: Oct. 1-Dec. 31
November 1
August 1
Quarter 3: January 1-March 31
February 1
November 1
Quarter 4: April 1-June 30
May 1
February 1
The total quarterly funds available for the pay for performance incentive payment is divided by the total MA days for all county nursing facilities meeting the qualifying criteria. The MA days used for each county nursing facility will be the paid MA days identified on the most recent PROMISe data file used to determine eligibility for disproportionate share payments.
Pay for Performance (P4P) Incentive Payments
Pay for performance (PRP) incentive payments are be made to qualifying county nursing facilities each quarter of the fiscal year based on qualifying criteria.
A county nursing facility will qualify for the P4P incentive payment if both of the following criteria are met:
The facility is a county nursing facility at the time of payment.
The facility's Medicaid case mix index (CMI) for the picture date is higher than its facility Medicaid CMI for the previous picture date.
P4P Payment Period
Picture Date
Pervious Picture Date
Quarter 1: July 1-Sept. 30
August 1
May 1
Quarter 2: Oct. 1-Dec. 31
November 1
August 1
Quarter 3: January 1-March 31
February 1
November 1
Quarter 4: April 1-June 30
May 1
February 1
The total quarterly funds available for the pay for performance incentive payment is divided by the total MA days for all county nursing facilities meeting the qualifying criteria. The MA days used for each county nursing facility will be the paid MA days identified on the most recent PROMISe data file used to determine eligibility for disproportionate share payments.