Alternative Models for Ensuring Access to Primary Medical Care in Nursing Facilities

Will placing medical practitioners on staff at nursing facilities increase the provision of primary care services and improve health outcomes of residents? This project conducted by the New York State Department of Health demonstrated four models for providing primary care in nursing facilities: 1) non-staff physicians in the community provide care on a fee-for-service basis when requested by the facility's nursing staff (the traditional model), 2) a staff physician provides primary care services to all residents, 3) staff nurse practitioners work collaboratively with the facility's medical director, and 4) staff physician assistants work collaboratively with a staff physician. The researchers compared the quality of care, health outcomes and costs associated with each model to determine which are most cost-effective.