On March 24, 2016, CMS announced it will test whether a new payment model for nursing facilities and practitioners will further reduce avoidable hospitalizations, lower Medicare and Medicaid spending, and improve the quality of care received by nursing facility residents.

 

CMS reports this next phase (Phase 2) of the Initiative to Reduce Hospitalizations among Nursing Facility Residents seeks to reduce avoidable hospitalizations by providing new payments to practitioners for engagement in multidisciplinary care planning activities. In addition, the participating skilled nursing facilities will receive payment to provide additional treatment for common medical conditions that often lead to avoidable hospitalizations. Through this model, CMS would facilitate practitioner engagement when a nursing facility resident needs higher intensity interventions due to a change in condition.

 

Phase 2 is slated to begin fall 2016, and will be implemented through cooperative agreements with six Enhanced Care and Coordination Providers (ECCPs). These ECCPs will work with existing partner facilities who participated in Phase 1 of the initiative in addition to new facilities to be recruited over the next several months. CMS envisions the Initiative to complement broader administration efforts to improve long term care facilities, including proposed updates to the conditions of participation for nursing homes, improvements to the five-star rating system for consumers, and implementation of the new Skilled Nursing Facility Quality Reporting Program that ties skilled nursing facility payment to the reporting of quality measures. For more information on this Initiative, please click here.