Medicare beneficiaries are spending 15% fewer per-capita days in skilled nursing facilities since 2009, according to a new analysis.

The trend likely reflects a drop in days in hospitals — whose practices should shape the business plans of skilled nursing providers, a vice president for consultancy Avalere Health told McKnight’s. “To increase their market share, skilled nursing organizations need data on the specific hospital referral patterns in their market,” said Fred Bentley, who oversees the firm’s post-acute division.

“They need to be able to size up the competition in terms of market share shifts and performance; they also need to have a much more nuanced, targeted understanding of the unique needs of their upstream hospital and ACO partners.”

In 2009, there were 1,808 SNF days per 1,000 Medicare fee-for-service beneficiaries. That number sank to 1,539 in 2016. The Avalere report blames the drop on less inpatient hospital care, including fewer admissions and more frequent use of “observation” stays, which result in fewer Medicare-covered SNF discharges.