The Revolving Door of Rehospitalization From Skilled Nursing Facilities

full'text ►The Revolving Door of Rehospitalization From Skilled Nursing Facilities: "The Revolving Door of Rehospitalization From Skilled Nursing Facilities
Vincent Mor, PhD, Orna Intrator, PhD, Zhanlian Feng, PhD, and David C. Grabowski, PhD*
Vincent Mor, Brown University;
Contributor Information.
*Corresponding author. Tel: 617-432-3369; Fax: 617-432-3435; grabowski@med.harvard.edu; Address: Harvard Medical School, Department of Health Care Policy, 180 Longwood Avenue, Boston, MA 02115-5899, USA.


Abstract
Medicare policymakers have recently become interested in changing the payment incentives around rehospitalizations. Using merged claims data, our analyses indicate 23.5% of Medicare beneficiaries discharged from the hospital to a skilled nursing facility (SNF) were directly readmitted within 30 days at a cost to Medicare of $4.34 billion in 2006. Although these results indicate significant potential savings, we also found that SNF rehospitalizations were heterogeneous in nature and varied considerably across local areas based on practice patterns. Medicare payment reform needs to account for incentives that vary geographically and by type of hospitalization in order to be effective.

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