A new study out of Brown University takes a closer look at how private Medicare plans are attempting to influence which skilled nursing facilities patients use, and for how long.
Researcher Emily Gadbois, Ph.D., and coauthors noted that Medicare Advantage plans are typically giving patients specific lists of facilities that they can use where their care would be covered. And aiming to lower lengths of stay, plans are authorizing stays for only a certain number of days, and requiring that SNFs stick to those time limits, shows the analysis, published Monday in the American Journal of Managed Care.
Researchers came to their conclusions by interviewing more than 150 staffers working in 25 SNFs and with 10 Medicare Advantage plans, across eight markets.
They noted that, while plans typically put a time limit on lengths of stay, they often did not provide guidance or assistance to ensure those goals were met. Both SNF and hospital responses to these systems were “frequently negative” and “participants expressed concerns about potential unintended consequences,” researchers found.
Authors expressed concerns that MA plan restrictions on SNF choice and length of stay could end up hurting patients in the long run.
“Exerting too much influence over hospitals and SNFs, as these results seem to indicate, may have the negative consequences of delayed hospital discharge and SNFs’ avoidance of burdensome plans,” study authors concluded.