Medicare study centered on nursing homes shows quality gaps | I Advance Senior Care Skip to content Skip to navigation

Medicare study centered on nursing homes shows quality gaps

January 19, 2018
by I Advance Senior Care
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According to an article from Reuters, researchers at Brown University’s School of Public Health examined Medicare beneficiaries entering skilled nursing facilities (SNFs) from 2012 to 2014. The yardsticks for quality were Nursing Home Compare - Medicare’s own database of nursing home quality ratings - and rates of hospital readmission for those admitted to SNFs. Their key finding: Medicare Advantage enrollees appear more likely to enter lower-quality skilled nursing facilities than people enrolled in traditional fee-for-service Medicare.

The SNF quality gaps could impact a large group of people, considering the large - and growing - Medicare population. David Meyers, one of the Brown University study authors, calculates that about 315,000 patients from lower-rated Advantage plans need to use an SNF annually. “If those people had used fee-for-service Medicare, up to 13,000 more of them might have gone to a higher-quality nursing home,” he said.

The study does not conclude that healthcare outcomes are necessarily worse for Medicare Advantage enrollees - that was outside the scope of the research. Some researchers have correlated NHC star ratings with patient outcomes, but the jury really is out on this question - partly because of the shortcomings of NHC itself. Much of the data that determines ratings is self-reported by nursing homes, and reviews of this system have found numerous cases of facilities attempting to “game” the system to inflate their ratings.

Read more about quality of care, Medicare, and SNFs at Reuters.