Incentivizing high nursing home staffing levels in the U.S. could result in 6,142 fewer hospitalizations each year, according to a study published Jan. 16 in JAMA Health Forum.
The study was conducted by researchers from Bethlehem, Pa.-based Lehigh University, Baltimore-based Johns Hopkins University, Washington, D.C.-based Georgetown University and the University of California, Los Angeles.
Researchers analyzed Medicare claims between the second quarter of 2021 and the third quarter of 2023 to compare health outcomes of nursing home residents before and after Illinois implemented a policy that incentivized higher staffing levels.
Here are three things to know from the study:
- In 2022, Illinois implemented a nursing home payment reform that provided bonus reimbursements of up to $36.68 per Medicaid resident-day based on acuity-adjusted staffing levels.
- Researchers compared resident health outcomes before and after the reform was implemented with two control groups: high-Medicaid facilities in other states and low-Medicaid facilities in Illinois.
Both analyses found that higher staffing levels were associated with substantial improvements for residents’ independence in activities of daily living. They found that an estimated 6,142 fewer hospitalizations would occur each year if a similar reform was implemented nationally.
- “These changes … should be interpreted cautiously,” the study authors said. “Because bonus payments were based on acuity-adjusted staffing levels, facilities could increase their payments by reporting residents as low acuity and requiring little ADL-related care. It is therefore possible that reductions in ADLs reflect strategic downcoding rather than real health improvements.”
Read the full study here.
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