Obama Administration Spending Millions to Keep Nursing Home Residents Out of the Hospital

By Susan Jones http://cnsnews.com/news/article/obama-administration-spending-millions-keep-nursing-home-residents-out-hospital
March 16, 2012

(CNSNews.com) – The Obama administration plans to spend up to $128 million looking for ways to keep nursing home residents out of the hospital.

As part of the Obamacare initiative, the Centers for Medicare & Medicaid Services will partner with independent organizations to improve care for people who live in nursing homes. Nearly two-thirds of them are enrolled in Medicaid, and most also are enrolled in Medicare.

These Medicare-Medicaid enrollees are among the most vulnerable individuals served by the programs and generally have the most complex health care needs, CMS said.

“Being readmitted to a hospital is very difficult for low-income seniors, people with disabilities and their families,” said Acting CMS Administrator Marilyn Tavenner. “Through this initiative, we will work with nursing facilities and hospitals to provide better, person-centered care. By catching and resolving issues early, we can help people avoid costly and stressful hospitalizations.”

The grants will go to independent organizations — such as physician practices and care management groups — that can provide “coordinated, person-centered care with the goal of reducing avoidable hospital stays.”

The initiative essentially will boost nursing home staff: Grant recipients must hire staff who “maintain a physical presence at nursing facilities” to provide preventive services.

CMS research on Medicare-Medicaid enrollees in nursing facilities found that approximately 45 percent of hospital admissions among those receiving either Medicare skilled nursing facility services or Medicaid nursing facility services could have been avoided, accounting for 314,000 potentially avoidable hospitalizations and $2.6 billion in Medicare expenditures in 2005.

The ‘Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents’ will be run collaboratively by the CMS Medicare-Medicaid Coordination Office and the Center for Medicare and Medicaid Innovation, both created by the Affordable Care Act to improve the quality and costs of care in the Medicare and Medicaid programs.

Interventions will be evaluated for their effectiveness in improving health outcomes. he initiative is expected to last for four years from August 2012 to August 2016.

Groups interested in the grant opportunity must submit an application by June 14, 2012