Skilled Nursing Facility Participation in Bundled Payments Was Related to Small Increases in Nurse Staffing Levels-Reference-Cited by-同舟云学术

Skilled Nursing Facility Participation in Bundled Payments Was Related to Small Increases in Nurse Staffing Levels

Published:2022-11-02 Issue:3 Volume:42 Page:456-463
ISSN:0733-4648
Container-title:Journal of Applied Gerontology
language:en
Short-container-title:J Appl Gerontol

Author:

Ying Meiling¹²^ORCID,Temkin-Greener Helena¹,Thirukumaran Caroline P.¹³,Joynt Maddox Karen E.⁴⁵,Holloway Robert G.⁶,Li Yue¹

Affiliation:

1. Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA

2. Department of Urology, Dow Division of Health Services Research, University of Michigan Medical School, Ann Arbor, MI, USA

3. Department of Orthopaedics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

4. Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St Louis, MI, USA

5. Center for Health Economics and Policy, Institute for Public Health at Washington University in St Louis, St. Louis, Missouri, USA

6. Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

Abstract

Medicare implemented Bundled Payments for Care Improvement (BPCI) Model 3 in 2013, in which participating skilled nursing facilities (SNFs) were accountable for episode costs. We performed comparative interrupted time series analyses to evaluate associations between SNF BPCI participation and nurse staffing levels, using Medicare claims, resident assessments, and facility-level and market-level files of 2010–2017. For persistent-participating SNFs, BPCI was associated with improved certified nursing assistant (CNA) staffing levels (differential change = .03 hours, p = .025). However, BPCI was not related to changes in registered nurse (RN) and all licensed nurse hours, and nurse skill mix. Among drop-out SNFs, BPCI was associated with increased RN staffing levels (differential change = .02 hours, p = .009), leading to a higher nurse skill ratio (0.51 percentage points, p = .016) than control SNFs. Bundled payments for care improvement had no impact on CNA and all licensed nurse staffing levels. In conclusion, BPCI was associated with statistically significant but small increases in nurse staffing levels.

Publisher

SAGE Publications

Subject

Geriatrics and Gerontology,Gerontology

Link

http://journals.sagepub.com/doi/pdf/10.1177/07334648221137060

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