Nursing facilities and managed care

Objective: To examine the extent to which Illinois nursing facilities have developed relationships with other healthcare providers, particularly manag ed cave organizations (MCOs). Study Design: A cross-sectional survey of nursing facilities designed to de termine: 1) relationship objectives; 2) obstacles to developing relationshi ps; 3) currrently available services; 4) staffing for these services and; 5 ) nursing facility approaches to networking. The survey was sent to a censu s sample of 867 nursing facilities sewing the elderly in Illinois. Descript ive and multivariate logistic regression analyses of relationships determin ed to be formal/risk-sharing were performed. Study Population:The sample included 523 Illinois nursing facilities. A tot al response rate of 60% was achieved (523/867). Results: Higher strategic goals, urban location, nonprofit ownership status , higher percentages of private pay and/or Medicare clients (vs Medicaid), and provision of home care and subacute services were all significant predi ctors of formal or risk-sharing relationships with MCOs. Conclusions: Facilities with more relationships and higher goals have more formal/risk-sharing relationships with MCOs, Facilities in urban areas have more relationships, likely due to the fact that rural facilities have fewe r options and operate in different markets. In addition, nursing facilities rely on Medicare referrals from hospitals, and these Medicare patients, es pecially those in urban areas, are increasingly controlled by MCOs.