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SB 1333

AN ACT CONCERNING VALUE-BASED MEDICAID REIMBURSEMENT TO NURSING HOMES.

2025 Regular Session Introduced by Mary Fortier and 3 co-sponsors

Connecticut moves nursing home Medicaid payments from fixed fees to outcome-based reimbursement, incentivizing quality but creating financial and access risks for providers and vulnerable residents.

HOUSE CALENDAR NUMBER 663
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Bill Summary · SB 1333

Legislative bill overview

SB 1333 establishes a value-based reimbursement system for nursing homes under Connecticut's Medicaid program, moving away from traditional fee-for-service payments toward payments tied to quality metrics and outcomes. The bill has passed the Connecticut Senate with amendments and is currently positioned for House consideration.

Why is this important

Nursing home reimbursement directly affects care quality, staffing levels, and facility viability, which impacts roughly 30,000+ Connecticut residents in long-term care. Value-based payment models aim to incentivize better patient outcomes and operational efficiency, but implementation challenges can significantly affect both provider sustainability and care access, particularly for vulnerable low-income populations who rely on Medicaid.

Potential points of contention

  • Provider financial impact: Nursing homes may struggle with transition costs and revenue uncertainty if quality benchmarks are set too aggressively, potentially reducing operational capacity or staff positions
  • Quality metric definition: Disagreement likely exists over which metrics best measure care quality and whether they appropriately account for differences in resident acuity, demographics, and facility resources
  • Access equity: Value-based models may inadvertently discourage admission of high-acuity or complex patients if reimbursement penalties for poor outcomes aren't carefully calibrated, potentially limiting care access for the most vulnerable residents

Compiled from official sources — confirm details with the bill’s official record.

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