Overview

There are several challenges to development of nonpayment policies for preventable adverse conditions. States considering such policies will need to decide which conditions to select for nonpayment, how to define those events or conditions, how to handle an event or condition that occurs during a care transition (e.g., from the hospital to a skilled nursing facility or patient's home), how and whether to differentiate between events that are "always" or "usually" preventable, how to ensure compliance with reporting, and more generally how to keep the focus on improving the care delivery system rather than assigning blame to providers.

The Snapshots in this issue describe nonpayment policies in Missouri, Kansas, Minnesota, and Maryland. These states participated in an October 2009 discussion on nonpayment policies hosted by the National Academy for State Health Policy and represent a range of implementation strategies.