Medicare and Medicaid Reimbursement Rates for Nursing Homes Motivate Select Culture Change Practices But Not Comprehensive Culture Change.
Components of nursing home (NH) culture change include resident-centeredness, empowerment, and home likeness, but practices reflective of these components may be found in both traditional and "culture change" NHs. We use mixed methods to examine the presence of culture change practices in the context of an NH's payer sources. Qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher (measured) environmental culture change implementation. Findings indicate that heightened coordination of Medicare and Medicaid could influence NH implementation of reform practices.
a Senior Health Policy and Health Services Researcher , RTI International , Washington , DC , USA.
Michael J
MJ
Lepore
Renée R
RR
Shield
Jessica
J
Looze
Denise
D
Tyler
Vincent
V
Mor
Susan C
SC
Miller
D000368:Aged; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D008484:Medicaid / Q000191:economics*; D006278:Medicare / Q000191:economics*; D009735:Nursing Homes / Q000191:economics*; D015279:Organizational Culture; D012052:Reimbursement, Incentive / Q000191:economics; D014481:United States
Medicaid; Medicare; culture change; mixed methods; nursing home