Version 1.2 Revised 7/20/2025
West Virginia
What Quality Measures are included in the Quality Incentive calculations?
Antipsychotic Medication (L)
Catheter Inserted/Left in Bladder (L)
UTI (L)
Depress Sx (L)
How is the Quality Incentive Payment calculated?
DatAlign uses the real time QM Scores calculated by DatAlign for chs.care for the four-quarter rolling period ending with the current quarter to simulate how current performance would impact reimbursement.
Points Assignment
West Virginia’s QIP points are provided by the West Virginia Department of Health and Human Resources.
Points Range: [5, 10, 15, 20, 25]
From Points to Dollars and Cents
The Quality Incentive Payment is calculated using the following formula:
Per diem Quality Payment rate × Points × Number of Medicaid days in the period
Per diem Quality Payment rate per point: $0.297010*
Number of Medicaid days in the period: The sum of the days of care in the period for patients whose primary payer is Medicaid.
References
Informational Quality Score Draft
*The Quality Payment rate per point was provided by Tracy R. Mitchell, CPA of Bradley Associates in November 2023
Version 1.2 Revised 7/20/2025