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CMS to Extend Initiative to Improve Care for Nursing Facility Residents

Posted on Thursday, August 27, 2015 2:40 PM

Today, CMS announced a new funding opportunity designed to enhance the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents. 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 Medicare and Medicaid spending, and improve the quality of care received by nursing facility residents.

Over the past three years, CMS has partnered with the seven Enhanced Care and Coordination Providers (ECCPs) to test a model to improve care for long-stay nursing facility residents. The ECCPs collaborate with 144 nursing facilities across seven states to provide on-site staff for training, to provide preventative services, and to improve the assessment and management of medical conditions.

The new payment is intended to reduce avoidable hospitalizations by funding higher-intensity interventions in nursing facilities for residents who may otherwise be hospitalized upon an acute change in conditions. Additionally, the model includes payments to practitioners similar to the payments they would receive for treating beneficiaries in a hospital. Practitioners would also receive new payments for engagement in multidisciplinary care planning activities.

The four-year payment phase of the Initiative is slated to begin in October 2016.

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