The effect of political control on financial performance, structure, and outcomes of US nursing homes

Blankart, Carl Rudolf; Foster, Andrew D.; Mor, Vincent

doi:10.1111/1475-6773.13061

Cited by 2 publications

(3 citation statements)

References 59 publications

(72 reference statements)

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“…Relevant facility-level and market-level covariates were adjusted for in regression analyses 34–38. SNF variables included occupancy rate, chain affiliation (yes/no), a case mix index, number of beds, ownership (for-profit, nonprofit, or government-owned), overall 5-star ratings, and number of selected BPCI episodes.…”

Section: Methodsmentioning

confidence: 99%

“…Relevant facility-level and market-level covariates were adjusted for in regression analyses. [34][35][36][37][38] SNF variables included occupancy rate, chain affiliation (yes/no), a case mix index, number of beds, ownership (for-profit, nonprofit, or government-owned), overall 5-star ratings, and number of selected BPCI episodes. County-level characteristics included annual average per capita income, unemployment rate, a measure of SNF market concentration determined by the Herfindahl-Hirschman index, urban location (yes/no), CMS SNF wage index, Medicare Advantage (MA) penetration, and ACO penetration.…”

Section: Covariatesmentioning

confidence: 99%

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Skilled Nursing Facility Participation in a Voluntary Medicare Bundled Payment Program

et al. 2021

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Importance: Model 3 of the Bundled Payments for Care Improvement (BPCI) is an alternative payment model in which an entity takes accountability for the episode costs. It is unclear how BPCI affected the overall skilled nursing facility (SNF) financial performance and the differences between facilities with differing racial/ethnic and socioeconomic status (SES) composition of the residents.Objective: The objective of this study was to determine associations between BPCI participation and SNF finances and across-facility differences in SNF financial performance.Design, Setting, and Participants: A longitudinal study spanning 2010-2017, based on difference-in-differences analyses for 575 persistent-participation SNFs, 496 dropout SNFs, and 13,630 eligible nonparticipating SNFs.Main Outcome Measures: Inflation-adjusted operating expenses, revenues, profit, and profit margin.Results: BPCI was associated with reductions of $0.63 million in operating expenses and $0.57 million in operating revenues for the persistent-participation group but had no impact on the dropout group compared with nonparticipating SNFs. Among persistent-participation SNFs, the BPCI-related declines were $0.74 million in operating expenses and $0.52 million in operating revenues for majority-serving SNFs; and $1.33 and $0.82 million in operating expenses and revenues, respectively, for non-Medicaid-dependent SNFs. The between-facility SES gaps in operating expenses were reduced (differential difference-in-differences estimate = $1.09 million). Among dropout SNFs, BPCI showed mixed effects on across-facility SES and racial/ethnic differences in operating expenses and revenues. The BPCI program showed no effect on operating profit measures.Conclusions: BPCI led to reduced operating expenses and revenues for SNFs that participated and remained in the program but had no effect on operating profit indicators and mixed effects on SES and racial/ethnic differences across SNFs.

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Section: Methodsmentioning

confidence: 99%

Section: Covariatesmentioning

confidence: 99%

Skilled Nursing Facility Participation in a Voluntary Medicare Bundled Payment Program

et al. 2021

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“…They could reflect how states have been left to adopt different regulatory approaches in response to state-level interests and local circumstances. Indeed, we suspect state officials may take such varied regulatory approaches in response to state-level market (e.g., number of AL communities) and social factors such as a high level of consumer demand for public oversight (Blankart et al, 2019; Hansen et al, 2019; Harrington et al, 2004, 2008; Wang et al, 2020). Our point-in-time survey of state agents does not provide sufficient power to conduct such hypothesis testing.…”

Section: Discussionmentioning

confidence: 99%

Promoting Quality of Life and Safety in Assisted Living: A Survey of State Monitoring and Enforcement Agents

Kaskie

Taylor

et al. 2021

Med Care Res Rev

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Our goal was to learn about monitoring and enforcement of state assisted living (AL) regulations. Using survey responses provided in 2019 from administrative agents across 48 states, we described state agency structures, accounted for operational processes concerning monitoring and enforcement, and documented data collecting and public reporting efforts. In half of the states, oversight of AL was dispersed across three or more agencies, and administrative support varied in terms of staffing and budget allocations. Operations also varied. While most agents could deploy a range of monitoring and enforcement tools, less than half compiled data concerning inspections, violations, and penalties. Less than 10 states shared such information in a manner that was easily accessible to the public. Future research should determine how these varied administrative structures and processes deter or contribute to AL communities’ efforts to implement regulations designed to promote quality of life and provide for the safety of residents.

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The effect of political control on financial performance, structure, and outcomes of US nursing homes

Cited by 2 publications

References 59 publications

Skilled Nursing Facility Participation in a Voluntary Medicare Bundled Payment Program

Skilled Nursing Facility Participation in a Voluntary Medicare Bundled Payment Program

Promoting Quality of Life and Safety in Assisted Living: A Survey of State Monitoring and Enforcement Agents

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