Nursing Facility Initiative Annual Report

By Patrick Conway, M.D., CMS Principal Deputy Administrator and Chief Medical Officer

Today we released the annual report summarizing impacts from the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents in 2014. This three-year-old initiative is designed to test ways to reduce avoidable hospitalizations among long-stay nursing facility residents. For such individuals, avoidable hospitalizations can be dangerous, disruptive, and disorienting. CMS research has estimated that 45% of hospitalizations among nursing facility residents could be prevented with well-targeted interventions.

The results in this report are based on experience during the second performance year of the initiative, calendar year 2014. During this period, all seven sites generally showed reductions in Medicare expenditures relative to a comparison group, with statistically significant declines in total Medicare expenditures at two sites. All sites also generally showed a decline in all-cause hospitalizations and potentially avoidable hospitalizations, with four sites showing statistically significant reductions in at least one of the hospitalization measures. These early results are promising.

As we plan for new Medicare payment incentives to reduce hospital readmissions from skilled nursing facilities, these results provide early indications that when the right strategies are in place, they may effectively reduce hospitalization rates and reduce overall Medicare spending.  We anticipate gaining an even more complete understanding of the initiative’s impacts as additional results from this initiative become available.

These promising early results come in tandem with impressive nationwide reductions in inappropriate use of antipsychotics for nursing facility residents through the National Partnership to Improve Dementia Care (http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-09-19.html). These results demonstrate additional progress on the nation’s path to a health system that achieves better care, smarter spending, and healthier people.

The full report is posted on the CMS website: [https://innovation.cms.gov/Data-and-Reports/index.html].

Additional information about the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents is available on the Medicare-Medicaid Coordination Office website: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/ReducingPreventableHospitalizationsAmongNursingFacilityResidents.html

 

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