Federal Watch

May 31st, 2012

AGS is tracking developments of interest to geriatrics health professionals in order to provide weekly updates for our readers via our List Serv, americangeriatrics.org, our Facebook page, and our Twitter feed.  This week, we update you on a new CMS initiative to improve dementia care in nursing homes; a look at the challenges of moving frail older adults from long-term-care facilities back into the community; and a reminder that PCORI funding for CER applications will begin on June 1. Finally, we share further news on AGS’s most recent activities, and encourage you to take action by contacting your legislators, and urging them to fully address and put an end to the flawed SGR formula. 

CMS Announces Partnership to Improve Dementia Care in Nursing Homes
The Centers for Medicare & Medicaid Services (CMS) announced the Partnership to Improve Dementia Care, an initiative to ensure appropriate care and use of antipsychotic medications for nursing home patients. This partnership – among federal and state partners, nursing homes and other providers, advocacy groups and caregivers – has set a national goal of reducing use of antipsychotic drugs in nursing home residents by 15 percent by the end of 2012. 

Unnecessary antipsychotic drug use is a significant challenge in ensuring appropriate dementia care. CMS data show that in 2010 more than 17 percent of nursing home patients had daily doses exceeding recommended levels. CMS and industry and advocacy partners are taking several steps to achieve this goal of improved care: 

• Enhanced training: CMS has developed Hand in Hand, a training series for nursing homes that emphasizes person-centered care, prevention of abuse, and high-quality care for residents. CMS is also providing training focused on behavioral health to state and federal surveyors;
• Increased transparency: CMS is making data on each nursing home’s antipsychotic drug use available on Nursing Home Compare starting in July of this year, and will update this data;
• Alternatives to antipsychotic medication: CMS is emphasizing non-pharmacological alternatives for nursing home residents, including potential approaches such as consistent staff assignments, increased exercise or time outdoors, monitoring and managing acute and chronic pain, and planning individualized activities. 

These efforts will help achieve the 15 percent reduction goal by the end of this year. In addition, to address this challenge in the long-term, CMS is conducting research to better understand the decision to use or not to use antipsychotic drugs in residents with dementia. A study is underway in 20 to 25 nursing homes, evaluating this decision-making process.  Findings will be used to target and implement approaches to improve the overall management of residents with dementia, including reducing the use of antipsychotic drugs in this population.  For more background, click here. 

States Encounter Obstacles Moving Frail Older Adults and Disabled into Community
Kaiser Health News reports on the status of a multi-billion dollar federal initiative launched during the Bush administration in 2007 to move low-income elderly and disabled people from long-term care facilities into the community.  The program has fallen far short of its goals, as many states have struggled to conjoin housing and other services; finding it to be a particular challenge to move  frail older adults. To read more on Kaiser Health News’ in depth analysis, click here. 

REMINDER:

Beginning June 1 - PCORI Funding Applications to Support CER
The Patient Centered Outcomes Research Institute (PCORI) will award $120 million this year for innovative projects that address the areas of focus of PCORI’s National Priorities for Research and Research Agenda, which was adopted by PCORI’s Board of Governors.. The four PCORI Funding Announcements released involve up to $96 million in funding and correspond to the first four areas of focus in PCORI’s National Priorities for Research and Research Agenda:

• Assessment of Prevention, Diagnosis, and Treatment Options– for projects that address critical decisions that patients, their caregivers and clinicians face with too little information
• Improving Healthcare Systems – for projects that address critical decisions that face health care systems, the patients and caregivers who rely on them, and the clinicians who work within them
• Communication and Dissemination – for projects that address critical elements in the communication and dissemination process among patients, their caregivers and clinicians
• Addressing Disparities – for projects that will inform the choice of strategies to eliminate disparities

To apply for a PCORI research project, applicants must first register using PCORI’s online system, which will be open beginning June 1, 2012. A link to the online system will be available on the PCORI Funding Announcements web page at http://www.pcori.org/funding-opportunities/pfa/. All application materials can be downloaded from the Funding Opportunities section of PCORI’s website. 

What AGS Did This Week
We submitted comments and recommendations to the House Ways and Means Committee regarding a new payment framework that will replace the unworkable Sustainable Growth Rate (SGR) system.  We stressed how imperative it is that a new payment system recognizes that frail older adults with multiple conditions are the patients who will benefit the most from transformation of Medicare into a patient-centered system focused on primary geriatric care, chronic care management, and coordination of care across settings. To read our letter, click here. 

How You Can Help 
AGS encourages you to Take Action by visiting AGS’ Health in Aging Advocacy Center. Contact your members of Congress today, and urge them to call for both the repeal of the SGR and comprehensive Medicare payment and delivery reform.  Should you have any questions, please don’t hesitate to contact Susie Sherman, Senior Coordinator of Public Affairs & Advocacy, ssherman@americangeriatrics.org. 

Modified On: May 31st, 2012