In June, McKnight’s reported that CMS is pushing for further reductions in antipsychotic use for people living with dementia in nursing homes. The 19.4% nationwide reduction achieved by the end of last year is just short of the 20% target set by CMS in 2012. There is a push for a total reduction of 25% this year and 30% by the end of 2016.
These are laudable goals, but can they be achieved? There is reason for concern. While there is great variation among individual homes, a graphing of the quarterly numbers over the past three years shows a pronounced flattening of the curve over the past year. Both the national numbers and those of most individual states show that they are reaching a plateau.
In fact, nearly half of all states found their antipsychotic use to be level or slightly increased over the last two quarters of 2014, and only 8 states had an absolute reduction of 2% or more over the prior year. Clearly, nursing homes have found all of the “low-hanging fruit”—the people whose drugs could be easily stopped—but most are having trouble figuring out how to take it to the next level.