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Related Experiment Videos

Nursing facilities and managed care.

M Guihan1, J M Erdman, D J Munroe

  • 1Institute for Health Services Research and Policy Studies, Northwestern University, Evanston, IL, USA. guihan@research.hines.med.va.gov

The American Journal of Managed Care
|October 28, 1999
PubMed
Summary
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Illinois nursing facilities with higher goals and urban locations are more likely to form formal relationships with managed care organizations (MCOs). These partnerships are crucial for navigating evolving healthcare markets.

Area of Science:

  • Healthcare management
  • Geriatric care
  • Health services research

Background:

  • Nursing facilities are increasingly interacting with external healthcare providers.
  • Managed care organizations (MCOs) play a significant role in coordinating patient care and managing costs.
  • Understanding the factors influencing nursing facility relationships with MCOs is vital for strategic planning.

Purpose of the Study:

  • To investigate the extent of relationship development between Illinois nursing facilities and other healthcare providers.
  • To specifically examine the nature and predictors of relationships with managed care organizations (MCOs).

Main Methods:

  • A cross-sectional survey was administered to 867 nursing facilities in Illinois.
  • Data collected included relationship objectives, obstacles, services offered, staffing, and networking strategies.

Related Experiment Videos

  • Descriptive and multivariate logistic regression analyses were used to identify predictors of formal/risk-sharing relationships.

    • Main Results:

    • Urban location, nonprofit status, and a higher proportion of private pay/Medicare clients predicted formal/risk-sharing relationships with MCOs.
    • Provision of home care and subacute services also significantly predicted these formal relationships.
    • Facilities with higher strategic goals demonstrated a greater likelihood of formal MCO engagement.

    Conclusions:

    • Nursing facilities with more developed networks and ambitious goals tend to establish formal/risk-sharing relationships with MCOs.
    • Urban facilities have more MCO relationships than rural ones, reflecting market differences and fewer options.
    • The increasing control of Medicare patients by MCOs, particularly in urban areas, highlights the importance of these facility-MCO collaborations.