For the study, researchers at the Perelman School of Medicine at the University of Pennsylvania used a database with Part B Medicare fee-for-service billings to determine generalist physicians and advanced practitioners who provided nursing home-based care from 2012 through 2015. The study authors defined “nursing home specialists” as clinicians who billed at least 90 percent of episodes from the nursing home.
The study found the number of nursing home specialists increased 33.7 percent, from 5,127 in 2012 to 6,857 in 2015. The number of nursing home specialists per 1,000 occupied beds went from 3.35 to 4.58 during that time period, an increase of 36.7 percent. The overall number of nursing home clinicians only slightly changed, from 33,218 in 2012 to 33,087 in 2015.
Study lead author Kira Ryskina, MD, an assistant professor at the Perelman School of Medicine, said the trend comes as nursing homes face increased pressure to improve quality, and offered insights.
“We don’t know how this trend will play out in the long term, but nursing home specialists have the potential to change the way healthcare is delivered in this setting,” she said.
She added, “On one hand, clinicians who practice in the nursing home exclusively could improve patient outcomes and reduce costs by leveraging expertise in nursing home processes of care, for example. But, concentrating patient care among nursing home specialists could also mean that patients are no longer seen by their primary care providers, who traditionally follow patients for years and across care settings.”
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