title: Nursing homes as acute care providers. A pilot study of incentives to reduce hospitalizations.
abstract: This program was designed to encourage treatment of episodes of acute illness in skilled nursing facilities in order to avoid costly and potentially traumatic admission to hospital. It is part of the Monroe County Long Term Care Program, Inc, system of case management and Medicare and Medicaid waivers, and consists of financial incentives, paid by Medicare, to facilities and to responsible physicians to evaluate and care for acutely ill patients in the SNF's when medically safe and feasible. A retrospective evaluation using a physician assessment committee concluded that among the first 112 patients in the program, 76% were very probably saved hospitalization or at least an emergency room visit. Acute bacterial infection was the most common category of episode, occurring in 46% of cases. Considerable savings to both Medicare and Medicaid were estimated to have resulted.
authors.affiliation: Department of Preventive, Family and Rehabilitation Medicine, University of Rochester School of Medicine and Dentistry, NY 14642.
authors.forename: J G
authors.initials: JG
authors.lastname: Zimmer
authors.forename: G M
authors.initials: GM
authors.lastname: Eggert
authors.forename: A
authors.initials: A
authors.lastname: Treat
authors.forename: B
authors.initials: B
authors.lastname: Brodows
mesh_terms: D000208:Acute Disease / Q000191:economics / Q000628:therapy*; D000368:Aged; D003365:Costs and Cost Analysis; D006760:Hospitalization; D006801:Humans; D006278:Medicare / Q000191:economics; D009518:New York; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D010347:Patient Care Planning / Q000191:economics; D010865:Pilot Projects; D012051:Reimbursement Mechanisms; D012052:Reimbursement, Incentive; D012189:Retrospective Studies; D014481:United States