CMS enhances funding to test new nursing facility payment model

CMS announced this week that it is infusing more funds into the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents.

For the past three years, CMS has partnered with seven Enhanced Care and Coordination Providers in 144 nursing facilities across seven states — Alabama, Indiana, Missouri, Nebraska, New York, Nevada and Pennsylvania — to test a model to improve care for long-stay residents. The ECCPs provide on-site staff for training, preventive services and helped improve the assessment and management of medical conditions.

The new funding opportunity will allow organizations currently participating in the initiative to apply to test whether a new payment model for nursing facilities and practitioners will further reduce avoidable hospitalizations, lower combined Medicare and Medicaid spending and improve the quality of care received by nursing facility residents, CMS said. 

"This initiative has the potential to improve the care for the most frail, most vulnerable Medicare-Medicaid enrollees — long term residents of nursing facilities," Tim Engelhardt, director of the Medicare Medicaid Coordination Office, said in a news release. "By aligning financial incentives, we can improve the quality of on-site care in nursing facilities and the assessment and management of conditions that too often now lead to unnecessary and costly hospitalizations."

This new four-year payment phase of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents, slated to begin in October 2016, will be subject to a rigorous external evaluation to determine the effects on cost and quality of care. Successful ECCP applicants would implement the payment model with both their existing partner facilities, where they provide training and clinical interventions, and in a comparable number of newly recruited facilities.

 

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