The changing market and nursing home care

Changes in Medicaid reimbursement will extend prospective payment systems for nursing homes nationwide by 1990. The new federal regulations will create economic incentives to admit more critically ill patients, since these patients will receive the highest reimbursement. Nursing home administrators will also look for ways to contain the costs of treating these patients without compromising care. Based on the New York state model, the author predicts increased presence of PAs in this setting. He calls for additional CME on nursing home medicine and encourages the AAPA both to study costs and functions of PAs in nursing homes and to appoint a committee to help federal and state planners develop appropriate regulations governing the use of PAs in nursing homes.