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Most skilled nursing facilities (SNFs) faced penalties in the 2024 Medicare Value-Based Purchasing (VBP) program. Facilities serving more Black or Hispanic patients, for-profit facilities, and those in urban or socioeconomically deprived areas were more likely to receive maximum penalties.

Keywords:
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Area of Science:

  • Health Services Research
  • Healthcare Policy
  • Gerontology

Background:

  • The Medicare Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) Program adjusts payments based on 30-day readmission rates.
  • Understanding facility-level factors associated with penalties is crucial for program improvement.

Purpose of the Study:

  • To identify facility-level characteristics linked to maximum penalties in the 2024 SNF VBP program.

Main Methods:

  • Retrospective, cross-sectional analysis of 10,278 SNFs using public CMS data for the 2024 SNF VBP program.
  • Logistic regression was employed to analyze associations between patient demographics, facility structure, and community factors with maximum penalty receipt.

Main Results:

  • A majority of SNFs (71.7%) received penalties, with 33.1% incurring the maximum penalty.
  • Higher proportions of Black and Hispanic patients, for-profit status, urban location, and socioeconomically deprived ZIP codes were significantly associated with increased odds of maximum penalties.
  • Facilities in the South region also showed a higher likelihood of maximum penalties.

Conclusions:

  • Penalties in the SNF VBP program are influenced by patient mix, ownership, and geographic factors.
  • Findings can inform policymakers on refining the SNF VBP program, targeting areas for quality improvement, and directing investments.