Government incentive program encourages nursing home care improvement

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Nursing homes improve critical care areas, such as fall and rehospitalization rates, when they collaborate with the government in a performance-based incentive program, according to new research.

Researchers from the Regenstrief Institute and the Indiana University Center for Aging Research analyzed Minnesota's Performance-based Incentive Payment Program and its effect on care quality in nursing homes. They found that participating facilities improved in target areas much more significantly than non-participant facilities. Plus, the participants maintained their quality improvement after the program ended.

Minnesota's approach encourages nursing homes to identify their problems, find evidence-based solutions and evaluate their outcomes, and is financed through state funding. This methodology allows providers and their staff to internalize quality improvement ideas.

"Organizational impacts extended beyond the PIPP projects themselves,” said Greg Arling, Ph.D., IU Center for Aging Research scientist and associate professor of medicine at the IU School of Medicine, and leader of the analysis, in a press release. “Facilities gave greater attention to evidence-based care practice, staff had more effective teamwork and communication, and better relationships emerged among nursing home management, staff, residents and family members."

The participating and non-participating nursing homes didn't vary greatly in terms of operating costs or total nursing staff hours per resident day. They also didn't vary in their measure of care quality or deficiency history.

The analysis is published in the September issue of Health Affairs.