A new analysis out of Brown University asserts that, while Medicare Advantage plans appear to direct patients to specific skilled nursing facilities, there has been no marked improvement in patient outcomes from that shift.

Investigators came to those conclusions after scouring data from more than 1 million Medicare Advantage enrollees who were newly admitted to SNFs between 2012 and 2014. They then analyzed MA’s impact on patients’ 180-day survival rate, 30-day hospital admissions and nursing home lengths of stay.

Possible explanations for the findings, they said, include that SNFs provide the same quality of care to all residents, regardless of enrollment, and that high concentrations of MA contracts may have positive spillover effects on patients enrolled in traditional Medicare. Plus, Medicaid pays for the largest share of long-term care (59%), and the influence of those Medicaid dollars may override any potential benefits from MA.

“Thus, if patient steering by MA contracts does not improve patient outcomes and may actually lead patients entering poorer quality nursing homes, should steering patients be encouraged?” study authors pondered. “More research is needed into any cost savings that steering by MA contracts may result in; however, these steering practices do not seem related to patient health outcomes.”