Vertical Integration Into Skilled Nursing Facilities and Hospital Readmission Rates.

Tory H Hogan, Christy Harris Lemak, Larry R Hearld, Jack Wheeler, Bisakha Pia Sen, Nir Menachemi
Author Information

Abstract

Following the Affordable Care Act (ACA), more hospitals vertically integrated into skilled nursing facilities (SNFs). Hospitals are now being penalized for avoidable readmissions, creating a greater demand for better coordination of care between hospitals and SNF. We created a longitudinal panel data set by merging data from the American Hospital Association's Annual Survey, CMS' Hospital Compare, and the Rural Urban Commuting Area data. Hospital and year fixed-effects models were used to examine the relationship between hospital vertical integration into SNF and 30-day pneumonia and heart failure (HF) readmission rates between 2008 and 2011. Our primary analyses modeled the impact of hospital vertical integration into SNF on 30-day readmissions for both pneumonia and HF using hospital and year fixed effects. Our secondary analyses examined whether hospital vertical integration into SNF was associated with a change in readmissions rates among different types of hospitals. Our results indicate that hospitals that vertically integrated into SNF were associated with a reduction in hospital 30-day pneumonia readmission rates (β = -0.233, p = .039). Vertical integration into SNF was not significantly associated with 30-day HF readmissions. Our secondary analyses found variation in the impact of vertical integration on readmission rates among different hospital organizational types.

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Grants

  1. T32 HS013852/AHRQ HHS

MeSH Term

Adult
Aged
Aged, 80 and over
Female
Health Care Costs
Humans
Longitudinal Studies
Male
Middle Aged
Patient Protection and Affordable Care Act
Patient Readmission
Retrospective Studies
Skilled Nursing Facilities
Surveys and Questionnaires
United States

Word Cloud

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