Nursing Home Patients Fare Better with On-Staff Primary Care Providers

Alternative models to ensure primary care access in nursing facilities

Health Research in Albany, N.Y., conducted a three-year demonstration project that examined differences in cost and quality among four alternative staffing models allowed under Medicaid for delivering primary care services in nursing homes.

This project was part of the Robert Wood Johnson Foundation (RWJF) national program Changes in Health Care Financing and Organization (HCFO).

Key Findings

  • The researchers found that:

    • The experimental closed staffing model showed both cost savings and improved quality of care when compared to the open staffing model control group.
    • Nursing home residents in the closed staffing model facilities experienced fewer total hospital admissions, shorter lengths of stay when hospitalized, and fewer visits to the emergency room.
    • The total cost savings to Medicaid and Medicare in these facilities was $1.7 million, or approximately $508 per patient per year.
    • The process of care was significantly better in the experimental group during the demonstration period.
    • A survey of residents showed that significantly more patients in the experimental group felt that they were examined more carefully, were able to express feelings, had better access to care, and felt the doctor cared and was friendly during the demonstration period.

The researchers concluded that having primary care providers on staff assures that nursing homes can provide care to residents as soon as it is needed.

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