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

Research output: Contribution to journalArticle

3 Citations (Scopus)

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)
JournalJournal of the American Geriatrics Society
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Patient Transfer
Nursing Care
Nursing Models
Nursing
Medicare
Hospitalization
Medicare Part B
Facility Design and Construction
Quality of Health Care
Medicaid
Quality Improvement
Dehydration
Urinary Tract Infections
Chronic Obstructive Pulmonary Disease
Pneumonia
Asthma
Heart Failure
Skin
Infection

Keywords

  • Hospitalization
  • Implementation science
  • Nursing facility
  • Quality improvement

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

@article{6375d2a971364f1c84e025310b162fc4,
title = "Improving Nursing Facility Care Through an Innovative Payment Demonstration Project: Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care Phase 2",
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.",
keywords = "Hospitalization, Implementation science, Nursing facility, Quality improvement",
author = "Kathleen Unroe and Nicole Fowler and Carnahan, {Jennifer L.} and Holtz, {Laura R.} and Susan Hickman and Shannon Effler and Russell Evans and Frank, {Kathryn I.} and Ott, {Monica L.} and Greg Sachs",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/jgs.15462",
language = "English (US)",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Improving Nursing Facility Care Through an Innovative Payment Demonstration Project

T2 - Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care Phase 2

AU - Unroe, Kathleen

AU - Fowler, Nicole

AU - Carnahan, Jennifer L.

AU - Holtz, Laura R.

AU - Hickman, Susan

AU - Effler, Shannon

AU - Evans, Russell

AU - Frank, Kathryn I.

AU - Ott, Monica L.

AU - Sachs, Greg

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

KW - Hospitalization

KW - Implementation science

KW - Nursing facility

KW - Quality improvement

UR - http://www.scopus.com/inward/record.url?scp=85050512185&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85050512185&partnerID=8YFLogxK

U2 - 10.1111/jgs.15462

DO - 10.1111/jgs.15462

M3 - Article

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

ER -