PMID: 9988283Feb 13, 1999Paper

Use of primary care teams by HMOS for care of long-stay nursing home residents

Journal of the American Geriatrics Society
D O FarleyD B Reuben


To characterize the use of formal primary care programs by health maintenance organizations (HMOs) for their members who are long-stay residents of nursing homes. Using mail survey techniques, 34 Medicare risk-contracting HMOs with the largest Medicare beneficiary enrollments were asked to complete a written questionnaire. HMOs were asked how they evaluate care in nursing home settings and whether they operate a formal primary care program for members who are long-stay nursing home residents. Those reporting they had programs were asked about the program features, participation in the program, roles performed by clinical practitioners, and clinical caseloads. Surveys were completed by 21 (61.8%) of the HMOs. HMO management personnel who know the primary care programs the HMOs operate in affiliated nursing homes. Descriptive summaries of the HMOs' responses to the survey questions were generated. For HMOs with primary care programs, caseloads of physicians and nurse practitioners were estimated using survey data reported by the HMOs. Eight (38.1%) of the responding HMOs operate formal primary care programs in affiliated nursing homes. HMOs with programs consider more factors than non-program HMOs in evaluating care for nursing h...Continue Reading


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Related Concepts

Health Maintenance Organizations
Health Services for the Aged
Homes for the Aged
Long-term Care
Nursing Homes
Patient Care Team
Primary Health Care
Utilization Review
Family Planning Program Evaluation
Geriatric Assessment

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