scholarly journals Assessing the Quality of Nursing Homes in Managed Care Organizations: Integrating LTSS for Dually Eligible Beneficiaries

2018 ◽  
Vol 55 ◽  
pp. 004695801880009
Author(s):  
Carrie Graham ◽  
Leslie Ross ◽  
Edward Bozell Bueno ◽  
Charlene Harrington
Keyword(s):  
Managed Care ◽  
Nursing Homes ◽  
Quality Criteria ◽  
Limited Attention ◽  
Home Networks ◽  
Services And Supports ◽  
Managed Care Organizations ◽  
Quality Of Nursing

Little is known about the quality of nursing homes in managed care organizations (MCOs) networks. This study (1) described decision-making criteria for selecting nursing home networks and (2) compared selected quality indicators of network and nonnetwork nursing homes. The sample was 17 MCOs participating in a California demonstration that provided integrated long-term services and supports to dually eligible enrollees in 2017. The findings showed that the MCOs established a broad network of nursing homes, with only limited attention to using quality criteria. Network nursing homes (602) scored significantly lower on 6 selected quality measures than nonnetwork (117) nursing homes. Low registered nurse and total nurse staffing were strong predictors of network nursing homes controlling for facility characteristics. Managed care organizations should consider greater transparency about the quality of their nursing homes and use specific quality criteria to improve the quality of their networks.

Managed Care Organizations' Assessment of Reimbursement for New Technology, Procedures, and Drugs

1999 ◽  
Vol 123 (8) ◽  
pp. 677-679
Author(s):  
Harold Zarkowsky
Keyword(s):  
Managed Care ◽  
New Technology ◽  
Third Party ◽  
Medical Community ◽  
Extensive Literature ◽  
Behavioral Measures ◽  
Randomized Controlled Studies ◽  
Marginal Improvement ◽  
Managed Care Organizations

Abstract Managed care organizations must establish formal processes for the evaluation of new technology, procedures, and drugs to enhance the quality of health care delivered and to support coverage and utilization decision making. Evidence-based research and the results of controlled clinical trials are the preferred sources of outcomes data to support the safety and effectiveness of the technology, procedure, or drug under review. In addition to extensive literature review, the opinion of experts in the field and acceptance by the medical community are considered. Assessments of new technology and drugs are available for purchase from several vendors, and managed care organizations can adopt or modify such evaluations to develop medical coverage policies. The research community can assist third-party payers by conducting studies on practices that might lead to substantial, rather than marginal, improvement in health, pay particular attention to study design when randomized controlled studies are not possible, and include functional and behavioral measures in analysis of outcomes.

Attitudes Toward Intelligent Technologies

2011 ◽  
pp. 231-252
Author(s):  
Lorenza Tiberio ◽  
Massimiliano Scopelliti ◽  
Maria Vittoria Giuliani
Keyword(s):  
Quality Of Life ◽  
Nursing Homes ◽  
Elderly People ◽  
Term Care ◽  
Care Services ◽  
Care Giving ◽  
Human Care

Nursing homes provide long-term care services and can help preserve the quality of life of elderly people subject to physical and cognitive impairments. In this chapter, we explore the role of intelligent technologies as a supplement to human care-giving and the potential to improve quality of life for both older adults and their caregivers in nursing homes. A study was conducted on elderly people’s and caregivers’ attitudes toward the use of intelligent technologies in nursing homes, with the aim of understanding in which domains of everyday activities the application of intelligent technologies can be more suitable. Results showed that attitude toward the application of intelligent technologies in nursing homes is positive, although multifaceted. Elderly people and caregivers considered intelligent technologies as relevant devices for the improvement of quality of life in different domains. Nonetheless, differences related to the role that technologies played in nursing homes clearly emerged.

scholarly journals Predictors of change over time in subjective daytime sleepiness among older adult recipients of long-term services and supports

2020 ◽  
Vol 32 (7) ◽  
pp. 849-861
Author(s):  
Darina V. Petrovsky ◽  
Karen B. Hirschman ◽  
Miranda Varrasse McPhillips ◽  
Justine S. Sefcik ◽  
Alexandra L. Hanlon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Daytime Sleepiness ◽  
Daily Living ◽  
Services And Supports ◽  
Over Time

ABSTRACTObjectives:Daytime sleepiness is associated with multiple negative outcomes in older adults receiving long-term services and supports (LTSS) including reduced cognitive performance, need for greater assistance with activities of daily living and decreased social engagement. The purpose of this study was to identify predictors of change in subjective daytime sleepiness among older adults during their first 2 years of receiving LTSS.Design and Setting:Secondary analysis of data from a prospective longitudinal study of older adults who received LTSS in their homes, assisted living communities or nursing homes interviewed at baseline and every 3 months for 24 months.Participants:470 older adults (60 years and older) newly enrolled in LTSS (mean = 81, SD = 8.7; range 60–98; 71% women).Measurements:Subjective daytime sleepiness was assessed every 3 months through 2 years using the Epworth Sleepiness Scale. Multiple validated measures were used to capture health-related quality of life characteristics of enrollees and their environment, including symptom status (Symptom Bother Scale), cognition (Mini Mental Status Exam), physical function (Basic Activities of Daily Living), physical and mental general health, quality of life (Dementia Quality of Life, D-QoL), depressive symptoms (Geriatric Depression Scale) and social support (Medical Outcomes Survey-Social Support).Results:Longitudinal mixed effects modeling was used to examine the relationship between independent variables and continuous measure of daytime sleepiness. Increased feelings of belonging, subscale of the D-QoL (effect size = −0.006, 95% CI: −0.013 to −0.0001, p = 0.045) and higher number of depressive symptoms (effect size = −0.002, 95% CI: −0.004 to −0.001, p = 0.001) at baseline were associated with slower rates of increase in daytime sleepiness over time.Conclusions:Comprehensive baseline and longitudinal screening for changes in daytime sleepiness along with depression and perceived quality of life should be used to inform interventions aimed at reducing daytime sleepiness among older adults receiving LTSS.

Managed Care Administrators' Opinion of Vocational Reahbilitation Services

1996 ◽  
Vol 27 (1) ◽  
pp. 42-44
Author(s):  
Reginald L. Gibbs ◽  
John M. Dodd ◽  
Anton Hecimovic ◽  
Elia Nickoloff
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Vocational Rehabilitation ◽  
The United States ◽  
Rehabilitation Services ◽  
Short Term ◽  
Managed Care Programs ◽  
Vocational Rehabilitation Services ◽  
Managed Care Organizations

Rising health care insurance premiums have forced many businesses and institutions to examine cost-cutting measures to lower health care costs. Managed care is one measure that has become widespread throughout the United States. The problem was to learn how managed care administrators view the role and purpose of vocational rehabilitation services in their organizations and if these services will lower short-term and long-term use. A survey was sent to the administrators of fifty managed care organizations in the states of Arizona, Colorado, Oregon, and Washington. Twenty of the fifty administrators responded to the survey. Results show that only one of the managed care organizations offered vocational rehabilitation services to their enrollees. The results also show that three responded that short-term use and ten responded that long-term use of managed care programs would be reduced if vocational rehabilitation services were offered.

Managed Care Takes to the Highway: Implications for Insureds

2001 ◽  
Vol 29 (2) ◽  
pp. 203-219
Author(s):  
Barbara J. Gilchrist
Keyword(s):  
Managed Care ◽  
State Legislatures ◽  
Health Care Expenditures ◽  
Insurance Companies ◽  
Automobile Insurance ◽  
Automobile Accidents ◽  
Automobile Accident ◽  
Accident Injuries ◽  
Managed Care Organizations

Automobile insurance companies are joining the move to managed care in the hopes of reducing health-care expenditures arising out of automobile accidents. Industry interest is strong enough that large managed care organizations, such as Concentra Managed Care, Inc., and HNC Insurance Solutions, are beginning to offer their existing network of providers to persons seeking medical care for automobile accident injuries and their evaluation software to insurers.While insurance companies have successfully pressed four state legislatures and one commissioner of insurance for authorization to offer consumers a managed care option in automobile insurance policies, these efforts have not gone unchallenged. Vocal opponents, primarily lawyer and chiropractic organizations, question whether persons injured in accidents will receive care when needed (especially if the accident occurs when the policyholder is away from home), what the quality of care received will be, and whether any savings will be passed on to consumers.

scholarly journals Factors Associated With Changes in Perceived Quality of Life Among Elderly Recipients of Long-Term Services and Supports

2016 ◽  
Vol 17 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Mary D. Naylor ◽  
Karen B. Hirschman ◽  
Alexandra L. Hanlon ◽  
Katherine M. Abbott ◽  
Kathryn H. Bowles ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Perceived Quality ◽  
Factors Associated ◽  
Perceived Quality Of Life ◽  
Elderly Recipients ◽  
Services And Supports
Sign in / Sign up

Export Citation Format

Share Document