Improving Nursing Facility Care Through an Innovative Payment Demonstration Project: Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care Phase 2.

Journal of the American Geriatrics Society
Kathleen T UnroeGreg Sachs

Abstract

Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) is a 2-phase Center for Medicare and Medicaid Innovations demonstration project now testing a novel Medicare Part B payment model for nursing facilities and practitioners in 40 Indiana nursing facilities. The new payment codes are intended to promote high-quality care in place for acutely ill long-stay residents. The focus of the initiative is to reduce hospitalizations through the diagnosis and on-site management of 6 common acute clinical conditions (linked to a majority of potentially avoidable hospitalizations of nursing facility residents): pneumonia, urinary tract infection, skin infection, heart failure, chronic obstructive pulmonary disease or asthma, and dehydration. This article describes the OPTIMISTIC Phase 2 model design, nursing facility and practitioner recruitment and training, and early experiences implementing new Medicare payment codes for nursing facilities and practitioners. Lessons learned from the OPTIMISTIC experience may be useful to others engaged in multicomponent quality improvement initiatives.

Citations

Apr 24, 2019·Journal of the American Geriatrics Society·Susan E HickmanGreg A Sachs
Jul 19, 2019·Journal of the American Geriatrics Society·Franziska ZúñigaMichael Simon
Feb 6, 2020·Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association·Susan E HickmanMary Ersek
Jun 5, 2020·Journal of General Internal Medicine·Jennifer L CarnahanKathleen T Unroe
Jun 25, 2019·Journal of Pain and Symptom Management·Kathleen T UnroeSusan E Hickman
Oct 12, 2020·Geriatric Nursing·Nestor Neil A PeigPamela S Miller
Apr 27, 2021·Journal of the American Medical Directors Association·Christine E KistlerSaif Khairat
Jun 29, 2021·Journal of the American Medical Directors Association·Hanna T WebbJennifer L Carnahan
Aug 14, 2021·BMC Health Services Research·Mark TolesJennifer Leeman

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