July 20, 2022
2:00-3:00 PM
Eastern Time
Reducing Avoidable Hospitalizations Among Nursing Home Residents:
Findings from an Evaluation of the CMS Initiative*
Speakers:
Galina Khatutsky, Lawren Bercaw, Micah Segelman, and Zhanlian Feng
ABOUT THE TOPIC:
Every year, about 25% of people who live in nursing facilities are transferred to hospitals for acute care. Avoiding unnecessary hospitalizations of nursing facility residents can improve resident health, increase quality of care, and reduce health care costs. While some of these transfers are required to treat specific health conditions or complications, many may be avoided through timely diagnosis and treatment within the nursing facility.
RTI evaluated a Centers for Medicare & Medicaid Services (CMS) Initiative to improve nursing facility resident health, increase care quality, and lower Medicare expenditures by reducing the number of avoidable hospitalizations. Using a mixed methods research design, the team collected and analyzed data to determine the CMS Initiative’s effects on hospital utilization, Medicare expenditures, and care quality.
Two phases were evaluated. The first phase (2012-2016) evaluated the value of providing on-site clinical support for nursing facilities, which are generally understaffed and struggle with staff recruitment and retention. The second phase of the Initiative added a Medicare payment component (2016-2020) to incentivize participating nursing facilities and practitioners to provide on-site acute care for eligible long-stay residents.
The session will discuss the research design and findings from this comprehensive and important evaluation.
*Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents (NFI) - https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/InitiativetoReduceAvoidableHospitalizations/AvoidableHospitalizationsamongNursingFacilityResidents
About the Speakers:
Galina Khatutsky, MS, is a senior policy analyst in the Aging, Disability, and Long-Term Care Program at RTI International and was a co-project director for the evaluation. In her research, she has focused on studying home- and community-based systems of care, nursing facilities, long-term services and supports financing, dually eligible Medicare beneficiaries, long-term care workforce, and access to and utilization of health services.
Micah Segelman, Ph.D., is a senior health policy researcher in RTI’s Center for the Health of Populations and was an associate project director for the evaluation. He has extensive experience in utilizing health services research methods to inform policy, particularly in the areas of long-term care and care for the elderly. Dr. Segelman has expertise in quantitative methods, including developing risk-adjusted quality measures and designing and conducting evaluations of policy interventions. He has extensive experience with Medicare data, Medicaid data, and the Nursing Home Minimum Data Set (MDS).
Lawren Bercaw, Ph.D., is a senior researcher within RTI’s Center for the Health of Populations and was an associate project director for the evaluation. Her areas of research include home- and community-based services, social determinants of health, and health equity for vulnerable populations. Dr. Bercaw’s qualitative research and leadership experiences include conducting more than 1,000 in-person and telephone interviews, leading focus groups, and coordinating technical expert panels with older adults, families, caregivers, physicians, nursing facility staff, and others who support diverse populations of older adults.
Zhanlian Feng, Ph.D., is a senior researcher in the Aging, Disability, and Long-Term Care Program at RTI International and was a co-project director for the evaluation. He studies long-term care access, quality, and costs. He is an expert in the use of large-scale administrative data sets, including Medicare and Medicaid claims, to address policy-relevant issues and uses sophisticated econometric analysis in quantitative evaluation approaches.
TO ACCESS THE MEETING:
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https://ahip-org.zoom.us/j/81721562668?pwd=fbeHg7vtzw8EeayoKxMxmYYR2Gqamr.1
Meeting ID: 817 2156 2668
Passcode: 537395
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