The Effects of Nursing Home Specialization in Post-Acute Care

35 Pages Posted: 13 Oct 2022

See all articles by Zachary S. Templeton

Zachary S. Templeton

University of Pennsylvania

Nate C. Apathy

University of Pennsylvania

R. Tamara Konetzka

University of Chicago

Meghan Skira

University of Georgia

Rachel M. Werner

University of Pennsylvania - Perelman School of Medicine

Abstract

Nursing homes serve both long-term care and post-acute care (PAC) patients, two groups with distinct financing mechanisms and requirements for care. We examine empirically the effect of nursing home specialization in PAC using 2011–2018 data for Medicare patients admitted to nursing homes following a hospital stay. To address patient selection into specialized nursing homes, we use an instrumental variables approach that exploits variation over time in the distance from the patient’s residential ZIP code to the closest nursing home with different levels of PAC specialization. We find that patients admitted to nursing homes more specialized in PAC have lower hospital readmissions and mortality, longer nursing home stays, and higher Medicare spending for the episode of care, suggesting that specialization improves patient outcomes but at higher costs.

Keywords: Post-acute care, nursing homes, skilled nursing facilities, specialization, Medicare

Suggested Citation

Templeton, Zachary S. and Apathy, Nate C. and Konetzka, R. Tamara and Skira, Meghan and Werner, Rachel, The Effects of Nursing Home Specialization in Post-Acute Care. Available at SSRN: https://ssrn.com/abstract=4246599 or http://dx.doi.org/10.2139/ssrn.4246599

Zachary S. Templeton

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

Nate C. Apathy

University of Pennsylvania ( email )

Philadelphia, PA 19104
United States

R. Tamara Konetzka

University of Chicago ( email )

1101 East 58th Street
Chicago, IL 60637
United States

Meghan Skira

University of Georgia ( email )

Athens, GA 30602-6254
United States

Rachel Werner (Contact Author)

University of Pennsylvania - Perelman School of Medicine ( email )

423 Guardian Drive
Philadelphia, PA 19104
United States

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