The Assistant Secretary for Planning and Evaluation (ASPE) contracted with the University of Colorado Health Sciences Center (UCHSC) to The Assistant Secretary for Planning and Evaluation (ASPE) contracted with the University of Colorado Health Sciences Center (UCHSC) to examine and describe models of physician practices in nursing homes; the financing arrangements and payment rates associated with these models; and determine what is known about the impact of physician practice models on the quality of care received by nursing home patients and on the quality of care provided in nursing homes. In the first phase of this project, the UCHSC completed a literature review related to physician practice patterns in nursing homes, including the: requirements related to such practices; extent to which medical schools prepare physicians to practice in nursing homes; level of physician practice and specialization in providing services in nursing homes; barriers to physicians practicing in nursing homes and innovative physician practice arrangements in nursing homes. The second phase of the study, which is presented in this report, was designed to further explore several issues that were not adequately addressed in the literature. Using information learned during the first phase, discussions were held in nursing homes and with key stakeholders in certain areas of the country to better understand the use and impact of various physician practice arrangements in nursing homes. This report summarizes discussions with stakeholders throughout the country in an attempt to identify obstacles and promising approaches to successful physician practices in nursing homes; synthesizes themes that recurred during the discussions; presents issues for further consideration; and offers potential areas for future research on physician practice in nursing homes.
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