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New CMS initiative to improve care for nursing home residents

March 25, 2016
by Nicole Stempak, Senior Editor
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The Centers for Medicare & Medicaid Services (CMS) wants to improve patient care, avoid unnecessary transfers and reduce costly hospital visits.

To that end, CMS announced Thursday it will test a new payment model will provide new payments to practitioners and nursing facilities for engagement in multidisciplinary care planning activities.

Practitioners would be brought into the facility when beneficiaries need higher-intensity interventions because of an acute change in condition. And Medicare will pay physicians the same amount for a comprehensive assessment at a Skilled Nursing Facility (SNF) as at a hospital.

Participating SNFs will also receive payment to provide additional treatments for common medical conditions that often lead to avoidable hospitalizations. SNFs will be expected to expand staff training and purchase new equipment to provide intravenous therapy and cardiac monitoring.

"This initiative has the potential to improve the care for the most frail, most vulnerable Medicare-Medicaid enrollees—long-stay residents of nursing facilities," says Tim Engelhardt, director of the Medicare-Medicaid Coordination Office in a press release. "Smarter spending 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."

The new four-year payment phase is part of of the Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents, a collaboration between the CMS Medicare-Medicaid Coordination office and the Center for Medicare and Medicaid Innovation. The initiative is scheduled to begin fall 2016 and will be implemented through cooperative agreements at six Enhanced Care and Coordination Providers.


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