Medicare and Medicaid Reimbursement Rates for Nursing Homes Motivate Select Culture Change Practices But Not Comprehensive Culture Change |
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| Authors: | Michael J. Lepore Renée R. Shield Jessica Looze Denise Tyler Vincent Mor Susan C. Miller |
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| Affiliation: | 1. Senior Health Policy and Health Services Researcher, RTI International, Washington, DC, USA;2. Adjunct Assistant Professor of Health Services, Policy, and Practice, Brown University, Providence, Rhode Island, USAMLepore@RTI.org;4. Professor of Health Services, Policy, and Practice (Clinical), Brown University, Providence, Rhode Island, USA;5. PhD Candidate, UCLA Fielding School of Public Health, Los Angeles, California, USA;6. Assistant Professor of Health Services, Policy, and Practice (Research), Brown University, Providence, Rhode Island, USA;7. Professor of Medical Science, Brown University, Providence, Rhode Island, USA;8. Professor of Health Services, Policy, and Practice (Research), Brown University, Providence, Rhode Island, USA |
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| Abstract: | ![]()
Components of nursing home (NH) culture change include resident-centeredness, empowerment, and home likeness, but practices reflective of these components may be found in both traditional and “culture change” NHs. We use mixed methods to examine the presence of culture change practices in the context of an NH’s payer sources. Qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher (measured) environmental culture change implementation. Findings indicate that heightened coordination of Medicare and Medicaid could influence NH implementation of reform practices. |
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| Keywords: | nursing home culture change Medicaid Medicare mixed methods |
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