Health Affairs June 1, 2025
Abstract
Medicare’s Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program is the largest pay-for-performance initiative ever implemented to improve care in SNFs. The program ties SNF performance in reducing thirty-day hospital readmissions among Medicare fee-for-service beneficiaries admitted from the hospital for postacute care to financial rewards or penalties of up to 2 percent of annual Medicare fee-for-service payments to SNFs. Using 2011–21 data from the Medicare Provider Analysis and Review files and other sources, we conducted a difference-in-differences analysis to determine whether the SNF VBP Program was successful in reducing thirty-day readmissions among the target population. Our analysis compared patient outcomes over time in SNFs in the highest quartile of Medicare-paid bed-days (which would be most sensitive to the...
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