State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Medicaid Up and Out


This was an initiative of Senator Locke Burt and was passed as part of SB1202. He was interested in replicating the Medicare HMO program Evercare for Medicaid patients in poor-performing nursing homes. The idea was to provide improved primary care for individual patients via a nurse practitioner who works with the Medical Director, the primary physician and the family to provide intensive case management.

The program has never been put into place. It was funded for $3 million dollars in 2001, but the funding was cut to $100K annually at the end of that legislative session. Evercare has provided a proposal which the State is reviewing. The proposal is in question because some are skeptical regarding whether implementation of the intervention at the individual level really will affect quality at the facility level. Evercare's reports show an improvement in some QIs, but not across the board. The State is unsure about how much latitude they have in spending the money and whether the proposal will be modified or eliminated.

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