Project to reduce antipsychotic use in nursing homes loses bid for federal grant
Massachusetts nursing homes, which recently pledged to lower their rate of antipsychotic use by 15 percent this year, found out Friday that they will not be receiving a coveted federal grant that would have helped fund the initiative to drive down inappropriate use of the powerful sedatives.
Under the proposal, developed by researchers at the University of Massaschusetts Medical School, nursing home staff would be trained on alternative methods of managing difficult behaviors by residents, particularly those with dementia, instead of relying on antipsychotic drugs to calm them.
Several other Massachusetts health initiatives were winners in the new federal program designed to improve health care quality and lower costs.
The Centers for Medicare & Medicaid Services announced 81 awards nationally on Friday, totalling $772 million. Combined with an earlier batch announced in May, the agency will fund 107 projects that are intended to save the health care system an estimated $1.9 billion over the next three years.
Massachusetts winners include the Vinfen Corporation, a Cambridge nonprofit organization that provides community-based services for people with psychiatric and developmental disabilities, and Northeastern University’s Healthcare Systems Engineering Institute.
Vinfen was awarded $2.9 million to help better coordinate mental health and primary care services for people with serious mental illnesss in Greater Boston.
Working with several partners, Vinfen aims to embed nurse-practitioners and primary care physicians with patients’ existing psychiatric caregivers to help them better manage their complex health issues.
“This is a population with multiple chronic medical problems like diabetes, and they are often high cost medical users,” said Bruce Bird, Vinfen’s president and chief executive. “We believe we can reduce unnecessary acute hospital and ER costs if we can provide better care where they are in the community.”
The company estimates that its project will save the health system nearly $3.8 million over the next three years.
Northeastern says the $8 million it was awarded to develop engineering solutions to complex health care problems in Massachusetts, Washington, and North Carolina will save nearly $61 million.
It said the program applies practices learned in industrial engineering and operations research to health care. These practices, which have been used in areas such as airlines and manufacturing, will be adapted to help improve patient flow through emergency departments and operating rooms, which can be costly.
Competition for the awards was stiff. Federal officials said they received 3,000 applications nationwide, and fewer than 4 percent were chosen.
The effort to reduce use of antipsychotics was among those not selected. A pilot program was launched last year in 11 nursing homes, but reseachers and the state’s nursing home trade association, Massachusetts Senior Care, had hoped to expand the initiative to more of the state’s 426 facilities.
A recent Globe series found a high rate of inappropriate use of antipsychotics at 28 percent of Massachusetts nursing homes, a larger percentage than at homes nationwide.
Scott Plumb, senior vice president of Massachusetts Senior Care, said it is committed to finding other sources of funding to expand the program.
“It is an excellent model, well tested, and a high priority for us and our members,” he said.
Also not funded was a proposal by researchers at Harvard Medical School to help reduce repeated hospitalizations of Massachusetts nursing home residents, which can be costly and disorienting for patients, particularly those with dementia.
The program uses teleconferencing to connect staff and families with physicians, particularly at odd hours, and resarchers said staff at 200 facilities had already received some training in the program. Plumb said his organization will also seek other funding to continue that initiative.
Also passed over in the federal awards was a proposal by Partners In Health, a Boston-based organization, to train community health workers to help coordinate medical care among Medicare and Medicaid patients in Lowell, New Bedford, Worcester, Framingham, and Holyoke.
Isaac Kastenbaum, manager of business development for the group, said it will pursue other funding for the proposal, or seek a partnership with a health care organization interested in piloting the program.Kay Lazar can be reached at firstname.lastname@example.org. Follow her on Twitter @GlobeKayLazar.