New Program to Improve Quality of Care for Nursing Home Residents in 7 States Announced by Medicare

The U.S. Centers for Medicare and Medicaid Services (CMS) announced Thursday awards of funding to seven organizations selected to partner with CMS and 145 nursing homes in seven different states in a new pilot program aimed at improving quality of care and reducing avoidable hospitalizations for nursing home residents.

According to a news release issued by CMS on September 27, 2012, “Research found that approximately 45 percent of hospitalizations among Medicare-Medicaid enrollees receiving either Medicare skilled nursing facility services or Medicaid nursing facility services could have been avoided. Total costs for these potentially avoidable hospitalizations for Medicare-Medicaid enrollees for 2011 were estimated to be between $7 and 8 billion.”

The new program “will test models to improve the quality of care and help reduce avoidable hospitalizations among nursing facility residents by funding organizations that provide enhanced on-site services and supports to nursing facility residents,” CMS said.

Through the new initiative, CMS will partner with seven organizations (in seven different states) that will collaborate with nursing facilities and State Medicaid programs to improve quality of care for long-term nursing facility residents.

The Seven Participating Organizations Selected to Partner with CMS and 145 Nursing Facilities

According to the CMS release, implementation of the new initiative will begin later this year at 145 nursing facilities in seven states in partnership with the following organizations:

• Alabama Quality Assurance Foundation (Alabama)
• Alegent Health (Nebraska)
• The Curators of the University of Missouri (Missouri)
• Greater New York Hospital Foundation, Inc. (New York)
• HealthInsight of Nevada (Nevada)
• Indiana University (Indiana)
• UPMC Community Provider Services (Pennsylvania)

“We view this initiative and the enhanced level of collaboration it will generate among a variety of providers as the key to reducing costly and avoidable hospitalizations for this population that often has the most complex health care needs,” said CMS Acting Administrator Marilyn Tavenner.

“All selected organizations will have on-site staff to partner with the existing nursing facility staff to provide preventive services as well as improve assessments and management of medical conditions,” CMS explained. “Participants will also work toward more seamless beneficiary transitions of care, and leverage use of emerging technologies, among many other activities. Each model will be subject to a rigorous external evaluation.”

The new Initiative will be run by the CMS Medicare-Medicaid Coordination Office and the Center for Medicare and Medicaid Innovation, both created by the Patient Protection & Affordable Care Act, with the mission of improving health care quality and reducing costs in the Medicare and Medicaid programs.

More Information

For more information on the new Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents, see:

• The CMS Website
• CMS Fact Sheet on the new Initiative

For more information about nursing homes and other senior care facilities and housing options, see the HelpingYouCare^® resource pages on About Senior Housing and Care Facilities, including:

• Introduction: Senior Housing & Care Facility Options – Understanding & Choosing
• About Continuing Care Retirement Facilities (CCRC’s)
• About Assisted Living
• About Nursing Homes & Rehabilitation Facilities
• About Hospice & Palliative Care
• Monitoring & Improving Quality of Your Loved One’s Care at a Care Facility

For more news and information about initiatives and assistance available under the Patient Protection & Affordable Care Act, President Obama’s signature Health Care Law, and about health care reform, see the HelpingYouCare^® resource pages on VoicesForCare™, including:

• News on Health Care Reform;
• Editorials: What Needs Improvement, With Your Comments;
• Advocacy: Proposals for Reform, With Your Comments;
• Legislation: Pending & Recently Adopted; and
• International Health Care Compare: Information on Health Care & Long-Term Care Solutions in Other Countries.

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