Alternative models to ensure primary care access in nursing facilities

The Foundation's Changes in Health Care Financing and Organization program was designed to support research, demonstration, and evaluation projects examining major changes in health care financing.The purpose of this project is to assess the cost and quality differences among four alternative team models recently allowed under Medicaid for the delivery of primary care in nursing facilities. The models include: (1) staff physicians only; (2) staff physician and nurse practitioner teams; (3) staff physician and physician assistant teams; and (4) traditional fee-for-service physician care. The objective of the study is to improve both the efficiency and effectiveness of primary care delivery in nursing facilities and to provide a model for other states. The New York State Department of Health will study the four models using a quasi-experimental design. Each of the three experimental models will be implemented in six nursing facilities representing urban, rural, voluntary, and proprietary facilities. Eighteen facilities with similar characteristics will serve as controls (fee-for-service). Data on treatments, costs, and health outcomes will be collected prior to implementation of the experimental models and again at 15 months post-implementation.

Grant Details

Amount Awarded $441,495.00

Awarded on: 4/16/1992

Time frame: 7/1/1992 - 3/31/1996

Grant Number: 20039


Health Research Incorporated

Riverview Center
150 Broadway, Suite 560
Menands, 12204-2726


Suzanne Moore
Project Director