title: Nursing home residents covered by Medicare risk contracts: early findings from the EverCare evaluation project.
abstract: 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.
authors: University of Minnesota School of Public Health, Minneapolis, Minnesota 55455, USA. kanex001@umn.edu
authors: Robert L
authors: RL
authors: Kane
authors: Shannon
authors: S
authors: Flood
authors: Gail
authors: G
authors: Keckhafer
authors: Boris
authors: B
authors: Bershadsky
authors: Yat-Sang
authors: YS
authors: Lum
mesh_terms: 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