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CMS initiative seeks to reduce avoidable nursing home hospitalizations

March 15, 2012
by Kevin Kolus
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The Centers for Medicare & Medicaid Services (CMS) is committing up to $128 million to reduce avoidable hospitalizations among nursing facility residents enrolled in Medicare and Medicaid, according to a new initiative announced Thursday.

The initiative aims to fund organizations that would partner with nursing facilities to provide enhanced on-site services to residents through evidence-based interventions.

Specifically, CMS will partner with independent organizations to improve care for long-stay nursing facility residents. These organizations would collaborate with nursing facilities and states to provide coordinated, person-centered care with the goal of reducing avoidable hospital stays.

Eligible organizations can include physician practices, care management organizations and other public and not-for-profit entities, CMS said in a release. 

Each organization will propose its own evidence-based intervention and improvement strategy. All participants would have staff on-site at nursing facilities to provide preventive services and improve coordination and communication among providers to create “a more seamless transition between care settings,” CMS said.

Approximately 45 percent of hospital admissions among residents receiving either Medicare skilled nursing facility services or Medicaid nursing facility services could have been avoided, accounting for 314,000 potentially avoidable hospitalizations and $2.6 billion in Medicare expenditures in 2005, according to CMS.

CMS issued a Request for Applications during the announcement. Organizations interested in participating in this initiative must submit an application by June 14, 2012. Click here for more information.

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