Daily Message

Feb. 5, 2016: CMS: Initiative Shows Promise in Reducing Hospitalizations for Nursing Home Residents

A federal initiative to improve care for long-stay nursing facility residents has yielded results in reducing hospitalizations, according to a new report from the Centers for Medicare and Medicaid Services.

Since September 2012, CMS has partnered with seven Enhanced Care and Coordination Provider (ECCP) organizations to improve care for long-stay nursing facility residents. The ECCPs collaborate with 143 nursing facilities across seven states to provide on-site staff for training and to provide preventive services and improve the assessment and management of medical conditions.

The 2014 annual report summarizes the impact of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents. All seven states – Alabama, Nebraska, Nevada, Indiana, Missouri, New York and Pennsylvania – showed reductions in Medicare spending relative to a comparison group. All sites also showed a decline in all-cause hospitalizations and potentially avoidable hospitalizations.

The initiative is focused on long-stay nursing facility residents who are enrolled in both the Medicare and Medicaid programs, with the goal of reducing potentially avoidable inpatient hospitalizations. CMS research has indicated that an estimated 45 percent of hospitalizations among nursing facility residents could be prevented with well-targeted interventions.

According to CMS, these early findings demonstrate that hospitalizations and overall Medicare spending can be reduced when the right strategies are in place. These results will be part of the planning for new Medicare payment incentives to reduce hospital readmissions from skilled nursing facilities.