health services

Neighborhood Health says Integrated Care Initiative results in fewer long-term nursing home placements

PETER MARINO, CEO and president of Neighborhood Health Plan of Rhode Island, said, “People who are older or disabled are often eager to remain in their homes and communities for as long as possible, and Neighborhood Health Plan of Rhode Island helps make that happen through our managed care programs."
PETER MARINO, CEO and president of Neighborhood Health Plan of Rhode Island, said, “People who are older or disabled are often eager to remain in their homes and communities for as long as possible, and Neighborhood Health Plan of Rhode Island helps make that happen through our managed care programs." PBN FILE PHOTO/RUPERT WHITELEY
3/20/17

SMITHFIELD – Close to 500 Rhode Islanders avoided long-term admission to a nursing home and another 150 Rhode Islanders were transitioned out of such placements as a result of Neighborhood Health Plan of Rhode Island’s work in support of the state’s Integrated Care Initiative, the insurer said Monday.

Neighborhood said it analyzed approximately three years’ worth of state and internal data to come up with its findings.

The ICI, Neighborhood explained in a news release, is part of a state effort to help people continue to live in the community with appropriate supports instead of being placed in a skilled nursing facility.

“People who are older or disabled are often eager to remain in their homes and communities for as long as possible, and Neighborhood Health Plan of Rhode Island helps make that happen through our managed care programs,” Peter Marino, Neighborhood’s president and CEO, said in a statement. “We know that Rhode Island’s seniors have the potential to be more physically and emotionally well when they are able to live independently. We also know that helping them do so can provide substantial cost savings to our state’s taxpayers.”

Since 2013, Neighborhood said its teams diverted 495 Rhode Islanders from long-term placements in skilled nursing facilities, helping them obtain and maintain independent living arrangements with needed supports and services. Those Rhode Islanders were initially sent to nursing facilities for short-term placements, it said.

Neighborhood said its care management teams partner with facilities and are involved with members’ discharge planning. That involves determining if a member can live independently in the community.

With the cost of nursing home care averaging $3,000 a month, each diversion potentially saves taxpayers $36,000 a year, Neighborhood said.

Neighborhood partnered with the state to launch the two-phase ICI in November 2013, targeting people dually-eligible for Medicare and Medicaid benefits.

Neighborhood said it also transitioned some Medicaid members who were already living in nursing homes back to home/community settings. Over the three-year period, Neighborhood transitioned 147 of these members from a nursing facility into independent living with community-based services.

Alison Croke, Neighborhood’s vice president of Medicare/Medicaid Integration, said that Neighborhood understands that in many cases, skilled nursing facilities can be the appropriate solution. However, she said a “substantial segment” of the population can live independently with appropriate supports.

“Those supports might come in the form of access to Neighborhood’s team of community health workers, a connection to an Adult Day health care facility, the availability of respite support for a primary caregiver, or any one of a number of other options,” Croke said.