Hospitals participating in bundled payment efforts are actively reducing their use of skilled nursing care, according to a study in the August issue of Health Affairs.

Centers for Medicare & Medicaid Services has undertaken two bundled payment initiatives, hoping to eradicate some of that cost variation.

To better understand how hospitals are navigating these waters, Penn researchers interviewed leaders at 22 institutions taking part in those two CMS bundled pay efforts.

It’s clear that hospitals are reducing SNF use and referrals, said lead author Jane Zhu, of Penn’s Perelman School of Medicine.

“[F]or certain patients, skilled nursing facilities offer no greater benefit and are more expensive than other venues,” she told McKnight’s.

Often, hospitals are reducing SNF referrals by using risk-stratification tools, better educating patients, providing care support at home, and linking with home health agencies to smooth discharge hiccups. Other hospitals, meanwhile, are.