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The Utilization, Application, and Impact of Institutional Special Needs Plans (I-SNPs) in Nursing Facilities: A Rapid
Michael Mileski1, Roland Shapley1, Bradley Beauvais1
1School of Health Administration, Texas State University, San Marcos, TX 78666, USA.
Abstract:
Background/Objectives: Institutional Special Needs Plans (I-SNPs) are designed to enhance the quality of care for long-term nursing facility (NF) residents. However, utilization patterns vary significantly, and their broader impact remains only partially understood. This rapid review aims to identify, map, and synthesize the existing literature on the use of I-SNPs in nursing homes. Methods: Following Arksey and O'Malley's framework and PRISMA-ScR guidelines, we conducted a comprehensive search of academic and gray literature using a predefined Boolean string. The extracted data were organized and analyzed thematically. Results: The synthesized literature (n = 12 studies) revealed four primary themes: (1) Market Penetration and Enrollment; (2) Models of Care Application; (3) Impact on Clinical and Financial Outcomes; and (4) Barriers to Utilization. Conclusions: I-SNP utilization represents a shift from fragmented FFS payment models toward integrated managed care within nursing facilities. Evidence shows a reduction in acute care transfers, although findings for other outcomes are mixed, underscoring the need for further research and policy development.
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