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Leveraging Value-Based Purchasing to Improve Advance Care Planning.

Susan E Hickman, Connie S Cole, Kathleen T Unroe

    Journal of Gerontological Nursing
    |February 1, 2022
    PubMed
    Summary

    Indiana incentivized advance care planning (ACP) training for nursing facility staff. This program successfully trained most staff, improving ACP education across the state and offering a scalable model for other states.

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    Area of Science:

    • Gerontology
    • Healthcare Administration
    • Medical Education

    Background:

    • Advance care planning (ACP) is crucial for person-centered care in nursing facilities.
    • Nursing facilities are legally required to offer ACP, but lack standardized staff training.
    • Inconsistent training leads to variable ACP quality, documentation, and decision re-evaluation.

    Purpose of the Study:

    • To evaluate the impact of incentivized advance care planning (ACP) training in Indiana nursing facilities.
    • To assess the reach and perceived value of the ACP Foundations Training program.
    • To propose a model for state-level ACP education initiatives.

    Main Methods:

    • Indiana integrated ACP training into its 2019 Value-Based Purchasing formula, awarding points for staff completion.
    • An "ACP Foundations Training" program was developed and offered to all Indiana nursing facilities.
    • Participation and participant feedback were tracked.

    Main Results:

    • 1,087 participants from 94.2% of Indiana nursing facilities completed the training.
    • Nearly all participants (99.4%) found the training practically valuable.
    • The initiative successfully disseminated basic ACP information statewide.

    Conclusions:

    • The academic-government partnership effectively provided essential ACP training to nursing facility staff in Indiana.
    • Incentivizing training through purchasing formulas is a successful strategy for disseminating educational content.
    • This model can be adopted by other states to enhance ACP education for nursing facility staff.