title: Efforts to improve primary care delivery to nursing home residents.
abstract: OBJECTIVE
  To describe a primary care practice model used by health maintenance organizations (HMOs) that serve medicare beneficiaries to improve the provision of primary care to nursing home residents.
  
  
  METHODS
  Medicare beneficiaries who reside in nursing homes and who are enrolled in HMOs.
  
  
  CONCLUSIONS
  Several HMOs are using physician-nurse practitioner teams to provide primary care to nursing home residents. The potential to improve the delivery of these services in nursing homes, particularly to long-stay residents, is apparent. However, obstacles arise in developing this practice model in HMOs, including difficulty recruiting both nurse practitioners and physicians and the lack of HMO-based research on the effects of such a model.
authors.affiliation: Robert Wood Johnson Foundation's National Program Office on Chronic Care Initiatives in HMOs, AAHP Foundation, Washington, DC 20036, USA.
authors.forename: T
authors.initials: T
authors.lastname: Fama
authors.forename: P D
authors.initials: PD
authors.lastname: Fox
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018588:Fee-for-Service Plans; D005260:Female; D006279:Health Maintenance Organizations / Q000592:standards*; D006801:Humans; D008134:Long-Term Care / Q000592:standards; D008297:Male; D006278:Medicare; D017146:Models, Organizational; D009735:Nursing Homes / Q000191:economics / Q000592:standards*; D010348:Patient Care Team; D011320:Primary Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D014481:United States