A program aiming to improve health and care for long-term residents of nursing homes has received a $16.9 million boost. Indiana University’s OPTIMISTIC initiative, which was launched four years ago, will use the latest round of Centers for Medicare and Medicaid Services funding to expand beyond central Indiana and more than double its presence. The program also involves new Medicare payments designed to reduce additional hospital admissions by funding in-place care for patients who become more ill.
IU School of Medicine Assistant Professor of Medicine Kathleen Unroe is project director for OPTIMISTIC and says hospitals and nursing facilities want fewer unnecessary transfers and admissions. Nineteen centers in Indiana participated in the initial phase of the program, which began in 2012. All will continue and 25 more will come on-board for the next four years.
Unroe explains "under the current CMS payment system, nursing facilities do not receive additional reimbursement to provide the care needed by residents who become sicker, unless the nursing home sends them to the hospital and then readmits them to the nursing home under the Medicare post-acute care benefit." She continues "in phase two of OPTIMISTIC, CMS supports testing to see if unnecessary hospitalizations will decrease if they provide nursing homes incentives to provide care in place."
The program will be funded for four more years. In all, CMS has put more than $30 million toward the program in Indiana. OPTIMISTIC, which stands for Optimizing Patient Transfers, Impacting Medical Quality and Improving Symptoms: Transforming Institutional Care," is one of six like it throughout the U.S.
IU says CMS estimates as much as 45 percent of hospitalizations of nursing facility residents "could be prevented with well-targeted interventions," saving hundreds of thousands of trips from nursing facility to the hospital and some $2.6 billion in Medicare expenditures. Conditions considered avoidable include: pneumonia, urinary tract infections, congestive heart failure, COPD/asthma, skin infection and dehydration.
You can read more about OPTIMISTIC by clicking here.
IU School of Medicine Assistant Professor of Medicine Kathleen Unroe is project director for OPTIMISTIC and says hospitals and nursing facilities want fewer unnecessary transfers and admissions.