Nursing home residents covered by Medicare risk contracts: early findings from the EverCare evaluation project.
OBJECTIVE
To compare the characteristics of a sample of EverCare nursing home residents with two control groups: one composed of other residents in the same homes and another made up of residents in matched nursing homes. To compare levels of unmet need, satisfaction with medical care, and the use of advance directives.


METHODS
Quasi-experimental design using two control groups to minimize selection effects. Information collected by in-person surveys of nursing home residents and telephone surveys of proxies and family members.


METHODS
Nursing homes affiliated with EverCare and matched control homes.


METHODS
Nursing home residents and their family members.


METHODS
Questionnaire addressing function (activities of daily living (ADLs)), unmet care needs, pain, use of advance directives, satisfaction, and caregiver burden.


RESULTS
In general, the experimental and control groups were similar, but the EverCare sample had more dementia and less ADL disability. Family members in the EverCare sample expressed greater satisfaction with several aspects of the medical care they received than did controls. Satisfaction of residents in the EverCare sample was more comparable with that of controls. There was no difference in experience with advance directives between EverCare and control groups.


CONCLUSIONS
EverCare appears to be a model of managed care worth tracking. It is producing care that is at least comparable with what is available in the fee-for-service environment, with evidence that families seem to appreciate the added attention. There is some suggestion that it has enrolled a less disabled but more demented population. Pending results on the effects of this care on hospitalization and emergency care should shed useful light.
Kane
Robert L
RL
University of Minnesota School of Public Health, Minneapolis, Minnesota 55455, USA. kanex001@umn.edu
Flood
Shannon
S
Keckhafer
Gail
G
Bershadsky
Boris
B
Lum
Yat-Sang
YS
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003258:Consumer Behavior; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D006278:Medicare; D009735:Nursing Homes / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014481:United States