Improving Nursing Facility Care Through an Innovative Payment Demonstration Project: Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care Phase 2

Kathleen T. Unroe, Nicole R. Fowler, Jennifer L. Carnahan, Laura R. Holtz, Susan E. Hickman, Shannon Effler, Russell Evans, Kathryn I. Frank, Monica L. Ott, Greg Sachs

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) is a 2-phase Center for Medicare and Medicaid Innovations demonstration project now testing a novel Medicare Part B payment model for nursing facilities and practitioners in 40 Indiana nursing facilities. The new payment codes are intended to promote high-quality care in place for acutely ill long-stay residents. The focus of the initiative is to reduce hospitalizations through the diagnosis and on-site management of 6 common acute clinical conditions (linked to a majority of potentially avoidable hospitalizations of nursing facility residents): pneumonia, urinary tract infection, skin infection, heart failure, chronic obstructive pulmonary disease or asthma, and dehydration. This article describes the OPTIMISTIC Phase 2 model design, nursing facility and practitioner recruitment and training, and early experiences implementing new Medicare payment codes for nursing facilities and practitioners. Lessons learned from the OPTIMISTIC experience may be useful to others engaged in multicomponent quality improvement initiatives.

Original languageEnglish (US)
Pages (from-to)1625-1631
Number of pages7
JournalJournal of the American Geriatrics Society
Volume66
Issue number8
DOIs
StatePublished - Aug 2018

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Keywords

  • hospitalization
  • implementation science
  • nursing facility
  • quality improvement

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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