April 6, 2016
The University of Missouri Sinclair School of Nursing today announced they have received nearly $20 million in funding from the U.S. Department of Health and Human Services Centers for Medicare &Medicaid Services (CMS) to expand their Missouri Quality Initiative for Nursing Homes. Through this program the Sinclair School of Nursing is working to create a national model for senior care and significantly reduce national health care spending.
“We have already seen monumental success from the Missouri Quality Initiative for Nursing Homes,” said Judith Fitzgerald Miller, dean of the Sinclair School of Nursing. “Just last month our researchers received kudos from CMS from the first phase of the project. Having the opportunity to expand this program showcases the university’s commitment to improving nursing homes and care of older adults not only in Missouri, but across the nation.”
Launched in 2012, the Missouri Quality Initiative for Nursing Homes is a partnership among MU, CMS and state Medicaid programs, and 16 collaborating nursing homes in St. Louis committed to improving care. The program is led by Marilyn Rantz, Curators’ Professor Emerita of Nursing and a team of MU researchers. The second phase of the program will take place at an additional 16 homes that have systems in place to manage the most common diseases associated with hospitalizations: pneumonia, dehydration, congestive heart failure, urinary tract infections, skin ulcers and asthma. Potentially eligible homes have already been identified by CMS and will be contacted shortly by the MOQI team.
“One of the challenges nursing homes face in determining care is the amount of payment they receive from CMS,” Rantz said. “This disparity in payment, between what hospitals are paid and the significantly less amount nursing homes are paid, leads nursing homes to hospitalize residents who could have been cared for in the home. For example, a physician can bill CMS $203 for a resident hospitalized with pneumonia, but a nursing home can only bill $136. This inequity means that decisions about resident care can come down to money, not what is best for the patient.”
As a result of the new funding, CMS has agreed to standardize payments under Medicare Part B for the treatment of qualifying conditions, increasing the amount paid to participating nursing homes for the treatment of conditions onsite. Rantz and her fellow researchers will then study whether the incentive of increased payment will help nursing homes reduce their hospitalization rate.
Since launching, the Missouri Quality Initiative for Nursing Homes has recruited and placed an advanced practice registered nurse (APRN) at 16 participating nursing homes. The APRNs worked with nursing home staff and health providers to coordinate patient care. One of the results of the project was a 34.5 percent decrease in potentially avoidable hospitalizations.
Rantz’s pioneering work in nursing homes care quality spans thirty years and she is regarded as a premier international expert in quality measurement in nursing homes and research programs to improve quality of care of older people.
Other MU nursing school researchers involved in the project include: Greg Alexander, professor Marcia Flesner, clinical instructor Jessica Mueller, program coordinator Lori Popejoy, associate professor Amy Vogelsmeier, associate professor MU researchers from other colleges and schools include: Colleen Galambos, professor in the College of Human Environmental Sciences’ School of Social Work Greg Petroski, biostatistician in the Medical Research Office.
Subcontractors on the grant are Primaris, a federally designated organization that works to improve health care quality and affordability for Missouri residents, and Missouri Health Connections, a non-profit organization that creates secure health information networks to connect patients and providers in the state.