Results from the Evaluation of the Massachusetts Nursing Home Connection Program
Abstract
The Nursing Home Connection, a demonstration project, test the use of nurse practitioners and physician assistants (NP/PAs) to improve quality of care in nursing homes. Within the project, physicians retain overall responsibility for patient care programs; however, Np/PAs perform duties and responsibilities delegated under 15 written protocols, including ordering tests, special diets, and rehabilitation therapy; and adjusting medications upon oral orders from the attending physician. The project obtained waivers from the Health Care Financing Administration (HCFA) that permit Medicare and Medicaid reimbursement for nursing home visits by NP/PAs and remove restrictions on billing frequency. The RAND Corporation, and the Schools of Public Health at the University of Minnesota and Boston University, evaluated this project. RAND had responsibility for the sampling design and the cost analyses. The University of Minnesota School of Public Health conducted the quality of care and outcomes analyses. Boston University designed and implemented the nursing home satisfaction survey. The results of all three components are reported here. This program, which encourages the use of NP/PAs for primary care in nursing homes, achieved modest improvements in quality of care without increasing costs. Further, both nursing home administrators and directors of nursing homes expressed higher levels of satisfaction with the process of care delivered under the demonstration model. (EMK) 28
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 1989
- Accession Number
- ADA227988
Entities
People
- Christina Witsberger
- Joan L. Buchanan
- Judith Garrard
- Robert L. Kane
- Robert M. Bell
Organizations
- RAND Corporation