# Advanced Provider Care Models and Health Outcomes of Nursing Home Residents with Dementia

> **NIH NIH RF1** · UNIVERSITY OF PENNSYLVANIA · 2024 · $2,278,636

## Abstract

PROJECT SUMMARY
The quality of care for the over 800,000 residents of US nursing homes (NH) with Alzheimer's disease or
related dementias (ADRD) is variable and outcomes are poor. The physician and advanced practitioner
(predominantly nurse practitioner) workforce plays a key role in the quality of care for NH residents with ADRD,
who tend to be more clinically complex and require more care coordination compared to residents without
ADRD. These clinicians work with direct care NH staff to diagnose and treat acute complaints, manage chronic
conditions, prescribe medications, perform minor procedures, and communicate with families about prognosis
and goals of care. However, little
care
clinician care models
characteristics
and
potentially
is known about the characteristics and outcomes of different NH clinician
models in the care of NH residents with ADRD. We propose to characterize and evaluate the
that provide general medical care to NH residents with ADRD. Understanding the
and outcomes of existing models of NH clinician care for residents with ADRD will inform policy
practice interventions to achieve higher quality care with better outcomes and l ower utilization of
avoidable healthcare that is particularly harmful in this population. Thus,
different NH
our long-term goal is to
improve the quality of care for NH residents with ADRD by evaluating and disseminating information on high-
performing NH clinician care models. To do so, we will survey a nationally representative sample of NH
clinicians about their practice characteristics, organization, processes of care, and degree of co-management
between different provider types. Next, we will link these data on NH clinician – predominantly NP-physician
models - to Medicare claims and the NH Minimum Data Set to measure the outcomes and costs of care for NH
residents with ADRD. We hypothesize that NH residents with ADRD under the care of clinicians with a high
degree of co-management (scores in the top vs. bottom quartile on the co-management scale) have better
outcomes (slower decline in functional status, fewer ambulatory care sensitive hospitalizations) and lower
costs (facility and professional payments by Medicare) compared to clinicians with a low degree of co-
management. This evidence will inform efforts by policymakers and NH providers to improve health outcomes
and reduce costs for NH residents with ADRD by aligning reimbursement, scope of practice, and regulations
mandating the timing of clinician visits, better supporting high-performing clinician care models for residents
with ADRD.

## Key facts

- **NIH application ID:** 10984193
- **Project number:** 1RF1AG085419-01A1
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Kira L Ryskina
- **Activity code:** RF1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $2,278,636
- **Award type:** 1
- **Project period:** 2024-09-01 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10984193

## Citation

> US National Institutes of Health, RePORTER application 10984193, Advanced Provider Care Models and Health Outcomes of Nursing Home Residents with Dementia (1RF1AG085419-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10984193. Licensed CC0.

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