Implementation of a CMS Nursing Facility Initiative: Differences by Racial Minority Resident Population.

Area of Science:

• Health Services Research
• Health Equity
• Nursing Home Quality

Background:

• The CMS Initiative to Reduce Avoidable Hospitalizations (NFI 2) aimed to reduce nursing facility hospitalizations through payment reform.
• Understanding disparities in program implementation based on resident demographics is crucial for equitable healthcare delivery.

Purpose of the Study:

• To examine how the racial composition of nursing facility residents influenced the implementation of the NFI 2 payment reform.
• To identify barriers faced by facilities serving larger racial minority populations.

Main Methods:

• Analysis of Medicare claims data.
• In-person and telephone interviews with facility staff.
• Assessment of NFI 2 engagement in relation to the racial minority resident population.

Main Results:

• Facilities with higher proportions of racial minority residents submitted fewer NFI 2 claims.
• These facilities reported greater challenges in engaging resident families.
• Increased staff and leadership instability was observed in facilities serving larger racial minority populations.

Conclusions:

• Facilities with larger racial minority resident populations encountered significant barriers to NFI 2 implementation.
• Addressing structural inequities within these facilities is necessary for future program development.
• Targeted programs may be needed to support diverse nursing facilities in achieving healthcare goals.