Though the Patient Driven Payment Model is driving many providers to take on more clinically complex residents, a new study shows that skilled nursing facilities that serve more frail patients are more likely to be penalized under Medicare’s SNF Value-Based Purchasing program.
A Washington University research team found that patient characteristics, such as frailty, and structural components, such as nursing home size, profitability and star ratings, could have a significant impact on providers’ performance under the SNF VBP program.
In addition, SNFs with lower nurse staffing had higher odds of being penalized, while nonprofit and government‐owned SNFs had lower odds. Not surprisingly, SNFs with higher star ratings had lower odds of being penalized.
Rural SNFs were less likely to be cited, while small SNFs were more likely.
SNFs located in low‐income ZIP codes were more likely to be penalized than others. Facilities with high proportions of mixed-race, black, Hispanic or disabled patients “did not have higher odds of penalization,” researchers stated.
“These findings have implications for policy makers and clinical leaders seeking to improve quality and avoid unintended consequences with VBP in SNFs,” they concluded.
Investigators used 2019 skilled nursing facility VBP performance scores and penalties for the analysis. In all, 72% of SNFs were penalized and 21% received the maximum penalty of 1.98%.
Findings were published online Wednesday in the Journal of the American Geriatrics Society.
