CMS encourages improvements for nursing facility residents
The new payment model will affect the facilities and the practitioners of nursing homes. If successful, it will decrease avoidable hospitalizations as well as reduce combined Medicare and Medicaid spending.
The Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents will offer practitioners new payment options when they complete multidisciplinary care planning activities. They will also receive payments for offering additional treatments for medical conditions that are common in nursing facilities and typically lead to hospitalizations that could have been avoided.
The new model will help to bring about higher-intensity interventions for acute changes in health conditions. As of today, Medicare pays less to physicians who provide comprehensive assessments inside skilled nursing facilities than the company pays for the same assessment completed at a hospital. Making these payments equal would remove the possible barriers that potentially affect the care that nursing facilities residents receive.
“This initiative has the potential to improve the care for the most frail, most vulnerable Medicare-Medicaid enrollees — long-stay residents of nursing facilities,” Tim Engelhardt, director of the Medicare-Medicaid Coordination Office, said. “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.”
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