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:

  1. The facility is a county nursing facility at the time of payment.
  2. 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 PeriodPicture DatePervious Picture Date
Quarter 1: July 1-Sept. 30August 1May 1
Quarter 2: Oct. 1-Dec. 31November 1August 1
Quarter 3: January 1-March 31February 1November 1
Quarter 4: April 1-June 30May 1February 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.