About The Program

Residential Outcome Payments are part of Inclusa’s Residential Rate Methodology (RRM). These outcomes allow Residential Providers to receive an additional payment when meeting certain criteria designed to promote member success. Payments are based on offering an additional level of care not captured within other areas of the RRM. The Residential Outcome Payments were created in partnership with residential providers as a way to build a reimbursement model to compensate for residential cares and create opportunities for providers who offer an additional level of care not captured within other areas of the RRM.

This year we will be introducing new Outcome Payment opportunities as well as providing more tools and resources to help residential providers ensure success within their individual projects. The projects place a greater emphasis on member outcomes specifically in the areas of Competitive Integrated Employment and Integrated Community Living. To allow for these exciting new opportunities, we will not be offering the Behavioral Health and Health Promotion related projects within this outcome cycle.

Payment Information

The outcome payment amounts will be determined in the Fall of 2020 when Inclusa receives its capitation rate from the State, if not currently identified within the specific outcome details; payments will then be distributed to eligible providers in the first quarter of 2021.

General Eligibility

  • Residential Outcome Payment opportunities are available to only those contracted residential providers utilizing the Inclusa’s RRM; some exceptions will be made regarding the Competitive Integrated Employment Outcome opportunity, please see additional details by following the associated link to the right.
  • All eligible providers must remain in good standing with Inclusa throughout the project year as determined by Inclusa, and any payments may be offset to providers who have an outstanding balance.

2020 Project Calendar

Download PDF Version of Calendar

*Please be advised that timelines have been adjusted to allow for more flexibility in light of the COVID- 19 pandemic, as well as additional considerations being built into the project resources and expectations. If further flexibility is needed please contact innovation@inclusa.org.

Additional Resources

Opportunities

Community Living
Competitive Integrated Employment
Quality Improvement