Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents (NFI)
Overview
The Medicare-Medicaid Coordination Office, in collaboration with the Center for Medicare & Medicaid Innovation, has undertaken efforts to improve the quality of care for people in long-term care (LTC) facilities
by reducing potentially avoidable inpatient hospitalizations.
The Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents, which ran from 2012 to 2020, focused on long-stay LTC facility residents, primarily those enrolled in the Medicare and Medicaid programs. The Initiative supported organizations that partner with LTC facilities to implement evidence-based interventions that both improve care and lower costs.
Background
L
TC facility residents often experience potentially avoidable hospital transfers. Unnecessary hospitalizations are expensive, disruptive, and disorienting for frail elders and people with disabilities. LTC facility residents are especially vulnerable to the risks that accompany hospital stays and transitions between nursing facilities and hospitals, including medication errors and hospital-acquired infections.
Many LTC facility residents are enrolled in both the Medicare and Medicaid programs (Medicare-Medicaid enrollees). CMS research on this population has repeatedly found that a large number of hospital admissions could have been avoided. More information can be found at the links below:
https://www.cms.gov/medicaid-chip/medicare-coordination/avoidable-hospitalizations
Here's another--
"Policy Points.
Misaligned incentives between Medicare and Medicaid
may result in avoidable hospitalizations among long‐stay nursing home residents.
"Providing nursing homes with clinical staff, such as nurse practitioners, was more effective in reducing resident hospitalizations than providing Medicare incentive payments alone.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9836234/
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