HealthInsight Nevada Selected to Facilitate Federal Nursing Home InitiativeLas Vegas – March 25, 2016 – HealthInsight, a private, nonprofit, community-based organization dedicated to improving health and health care, has been selected to carry out a four-year model to improve care for nursing facility residents in Nevada and Colorado. The model is slated to begin immediately with approximately $17 million in funding. It is Phase 2 of the Initiative to Reduce Avoidable Hospitalizations Among Nursing Facility Residents, an initiative HealthInsight’s Admissions and Transitions Optimization Program (ATOP) has been working on for the last four years.
In 2012, the Centers for Medicare & Medicaid Services (CMS) via the Centers for Medicare & Medicaid Innovation Center (CMMI) and the Medicare-Medicaid Coordination Office (MMCO) funded seven Enhanced Care and Coordination Providers (ECCPs) to test the first phase of the strategy through clinical and educational interventions. By hiring skilled clinicians and placing them in 24 Nevada facilities, HealthInsight’s ATOP program has been able to train staff to identify and treat early changes in condition for long-term-stay residents, which ultimately leads to fewer hospital transfers and a reduction in cost.
The next phase of the initiative looks to continue those care interventions, but adds a payment reform component. Nursing facilities that provide a higher level of care for six specific conditions that often result in hospitalization will be paid at a higher level. Practitioners will also see a change in pay. Prior to this phase, practitioners received higher compensation to treat the patient in the hospital. This strategy aims to equalize the pay between sites of care – meaning the physician will receive the same amount for treating the patient within the skilled nursing facility. An additional payment will be provided if the practitioner engages in multidisciplinary care planning activities.
ATOP will continue implementing clinical interventions in Nevada facilities and add the payment reform piece to the work. To measure effectiveness, ATOP will also work with 24 nursing facilities in Colorado to test the payment-only component of the intervention.
“HealthInsight Nevada is pleased to be selected by CMMI and MMCO to continue this important work in nursing facilities,” said Leslie Johnstone, vice president of operations for HealthInsight Nevada. “Inclusion of true payment reform in Phase 2 of this program shows a real shift to payment for value and supports HealthInsight’s work to improve the quality of care in our state’s nursing facilities.”