Managed Care and People With Disabilities Research Inventory. Managed Care and People With Disabilities Research Inventory : Table 41

02/01/1996

: Table 41

CONTACT PERSON NAME:   Steve Miller
ORGANIZATION:   HCFA (ORD)
TELEPHONE:   (410) 786-6656
NAME OF STUDY:   EverCare
PROJECT DIRECTOR/PI:   Marsha Smith, President of EverCare
FUNDING SOURCE:    
PROJECT DATES:   1995 - 2000
RESEARCH QUESTIONS/GOALS:   A demonstration initiative to study the effectiveness of managing the acute care needs of nursing home residents within a capitated managed care model. Major goals are to reduce medical complications and dislocation trauma resulting from hospitalization, and to save the expense of hospital care by managing patient care safely in nursing homes.
PROJECT DESCRIPTION:   Physicians will be paired with geriatric nurse practitioners who will function as primary medical caregivers and case managers; intensity and availability of medical services will increase. EverCare will be paid a fixed capitation payment for all nursing home residents enrolled and will be at full financial risk for the cost of acute care services for the enrollees. Physician incentive plans will be structured to offer a higher reimbursement rate for a nursing home visit and a lower reimbursement rate for services in their offices or other settings. Nine sites have implemented the demonstration.
BRIEF DESCRIPTION OF METHODS AND DATA:   HCFA will issue an RFP for an evaluation this spring.
AVAILABILITY OF RESULTS:   To be determined