Demonstration Project

OPTIMISTIC Care

Years of Research and Industry-Leading Experts

Data-Driven OPTIMISTIC Solutions

Indiana University’s OPTIMISTIC project was a $30.3 million Centers for Medicare and Medicaid services (CMS) Center for Innovation demonstration project. In the first phase of the project, registered nurses and nurse practitioners were embedded in 19 central Indiana nursing facilities to deliver a multicomponent program to reduce avoidable hospitalizations.

In phase two, an additional payment model was tested in a cohort of new facilities as well as our current facilities. OPTIMISTIC is led by Dr. Kathleen Unroe and Dr. Greg Sachs with the Indiana University Center for Aging Research at Regenstrief Institute and the Indiana University Division of General Internal Medicine and Geriatrics, together with our local partners, including the University of Indianapolis Center for Aging & Community. This integrated research and application project shed light on the changing long-term care industry and changed the way we think about long-term care and what that means for both facilities and patients.

$14.3

Billion

An HHS report found that 1 in 4 medicare recipients was hospitalized in 2011, costing CMS $14.3 Billion USD – nearly half were potentially avoidable.

Problems Faced:

Avoidable hospitalizations
Variations in care standards
Out of pocket expenses for patients

Restricted access to care
Lack of personalized care
Inefficient treatment documentation

Research Aimed To Solve The Most Pressing Nursing Home Challenges

The OPTIMISTIC vision was designed in collaboration with our partner nursing facilities and other relevant community partners. OPTIMISTIC integrates a suite of inter-related evidence-based practices targeting one or more causes of avoidable hospitalization. Many of these evidence-based strategies were developed by researchers at Indiana University or our consultants on this project. Thus, we have deep experience in the design and implementation of these models.

CMS funded

the creation of Enhanced Care Coordination Programs in 7 states

Embedded Nurse Practitioners and Registered Nurses

OPTIMISTIC required employed registered nurses to support partnering facilities

State-wide partnerships

19 nursing homes in central Indiana were provided a registered nurse and access to a nurse practitioner

“Our organization is focused on delivering the right care in the right place and one of our primary goals is to reduce avoidable hospitalizations. Our partnership with this program has helped us better understand more about why our residents are going to the hospital and how we can use our own resources to treat them in our facility. Having this nurse focused on our patient and educating our staff has strengthened our ability to ensure quality, efficient care.”

- Jeff Cooper, Executive Director, American Village

We focused on these Goals:

Improve Medical Care

Early recognition and management of acute conditions
Resident-centered, evidence-based chronic care management
Onsite training and mentorship for nursing home staff

Enhance Transitional Care

Improving provider-to-provider communication
Family and caregiver education of transition procedures
Focus on follow-up with receiving physicians

Support Palliative Care

Systematic advance care planning
Improved support and education for palliative care
Increased access to pain and symptom management

OPTIMISTIC Systems Resulted in Overall Savings and Improved Quality

With systems in place based on the research and data collected in the OPTIMISTIC project, we saw promising results from our 19 nursing homes across the state of Indiana. We saw increased staff knowledge and providers communication skills, increased staff understanding of end of life care, and a changed facility culture toward treating residents in-house.

33%

19%

25%

$3.4

Million

Reduced relative risk of potentially avoidable hospitalizations by 33%

Reduced relative risk of all hospitalizations by 19%

Reduced relative spending for avoidable hospitalizations by 25% per resident

Produced net savings of 3.4 million in Medicare expenditures

33%

Reduced relative risk of potentially avoidable hospitalizations by 33%

19%

Reduced relative risk of all hospitalizations by 19%

25%

Reduced relative spending for avoidable hospitalizations by 25% per resident

$3.4

Million

Produced net savings of 3.4 million in Medicare expenditures

See Optimistic Site

Combined Research to Create Probari

Armed with the knowledge gained from the OPTIMISTIC project, we built a system for advanced nursing home care and reduced overall costs. Probari brings the years of research and expert knowledge to nursing homes across the country. The new approach to care builds sustainable, cost-effective, hands-on care for those who need the best care from highly trained professionals. The nursing home industry is changing, it’s time to revolutionize the way we all approach long-term care.