Nursing homes more likely to send Medicaid recipients to hospital, study says

Share this article:
Nursing homes more likely to send Medicaid recipients to hospital, study says
Nursing homes more likely to send Medicaid recipients to hospital, study says

Medicaid beneficiaries in a nursing home are 27% more likely than private pay residents to be sent to a hospital rather than be treated on-site, according to a new study.

Researchers at the University of Rochester Medical Center analyzed records of 67,256 nursing home residents in 545 New York facilities. They said it was traditionally assumed that Medicaid patients were hospitalized more frequently because they were admitted to skilled nursing facilities with fewer resources.

But it's actually a question of money, the investigators found. Since Medicaid reimburses nursing homes at a rate lower than the cost needed to provide intensive care on-site, nursing homes have an incentive to send their residents to a hospital. The hospital and Medicare therefore absorb the costs of treating the sick resident, the investigators said.

“While we know that nursing homes tend to provide similar quality of care to all residents, hospitalization decisions are often different from the decisions involved in the provision of daily care and have a significant impact on the long-term health of residents,” said lead researcher, Shubing Cai, Ph.D., in a statement. The authors point to programs like a pay-for-performance project from the Centers for Medicare & Medicaid Services as a way to provide incentives for SNFs to decrease hospitalization rates.  

The study was published in the October issue of the journal Medical Care Research and Review.
Share this article:

More in News

Bulk of Medicaid to be managed care in two years: Avalere

Bulk of Medicaid to be managed care in ...

More than three-quarters of Medicaid beneficiaries will be enrolled in a managed care plan as of 2016, according to an Avalere Health analysis released Thursday. The numbers reveal that managed ...

Nursing home asked for employee's personal information too often, jury rules

The human resources department of a Maine nursing home did not properly protect a former employee's personal identification information, a jury recently ruled.

Test could confirm sepsis within an hour

Nursing home residents might benefit from a new way of diagnosing and treating sepsis made possible by discoveries out of the University of British Columbia.