Evidence map›Paper›PMID 40751494›Full record

ArticleJournal of the American Geriatrics Society2025

Penalties in 2024 in Medicare's Skilled Nursing Facility Value-Based Purchasing Program.

Sydney P Wheeler, Sunny C Lin, Gmerice Hammond, Khavya Avula, R J Waken, David C Grabowski, Michael L Barnett, Karen E Joynt Maddox

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sydney P WheelerWashington University School of Medicine, St. Louis, Missouri, USA.
Sunny C LinDivision of General Medicine and Geriatrics, Washington University School of Medicine, St. Louis, Missouri, USA.ORCID https://orcid.org/0000-0002-4979-9058
Gmerice HammondCenter for Advancing Health Services, Policy & Economics Research, Institute for Public Health, Washington University, St. Louis, Missouri, USA.
Khavya AvulaCenter for Advancing Health Services, Policy & Economics Research, Institute for Public Health, Washington University, St. Louis, Missouri, USA.
R J WakenCenter for Advancing Health Services, Policy & Economics Research, Institute for Public Health, Washington University, St. Louis, Missouri, USA.
David C GrabowskiDepartment of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA.
Michael L BarnettDepartment of Health Policy and Management, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.
Karen E Joynt MaddoxCenter for Advancing Health Services, Policy & Economics Research, Institute for Public Health, Washington University, St. Louis, Missouri, USA.ORCID https://orcid.org/0000-0003-3779-8653

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
NCATS NIH HHS UL1 TR002345NCATS NIH HHS UL1TR002345
6 · The paper itself

Abstract

backgroundThe Medicare Skilled Nursing Facility (SNF) Value-Based Purchasing Program (VBP) provides incentive or penalty payments to SNFs based on their 30-day readmission rates. Our objective was to identify facility-level characteristics associated with penalties in the 2024 program.

methodsThis retrospective, cross-sectional analysis of 10,278 SNFs used publicly available CMS data for the 2024 SNF VBP program. Using logistic regression, we analyzed the relationship between patient makeup (proportion of Black or Hispanic patients), structural characteristics (facility size, profit status, Medicare or Medicaid certification, hospital affiliation, SNF operating margin, and total nursing staff hours per resident per day), and community characteristics (ZIP SDI, rural versus urban location, region, and state average home health quality rating) on receipt of maximum penalty.

resultsMost SNFs participating in the 2024 SNF VBP were penalized (71.7%), with 33.1% of facilities receiving the maximum penalty of -1.98%. In multivariate regression models, facilities with a high proportion of Black residents (adjusted odds ratio [aOR] 1.14, 95% confidence interval [CI] 1.02-1.28) or Hispanic residents (aOR 1.42, 95% CI 1.26-1.60) and for-profit SNFs (aOR 1.42, 95% CI 1.26-1.61; vs. non-profit) were more likely to receive maximum penalties than their counterparts, as were those located in socioeconomically deprived ZIP codes (aOR 1.20, 95% CI 1.04-1.39), urban location (aOR 1.56, CI 1.35-1.81) or the South (aOR 2.32, 95% CI 1.98-2.71). Other measured characteristics were not associated with increased likelihood of maximum penalty.

conclusionPenalties under the Medicare Skilled Nursing Facility Value-Based Purchasing Program vary by key facility characteristics, including patient mix, ownership, and geography. This information may help inform policymakers on how to improve outcomes in new iterations of the SNF VBP program and identify areas where technical modifications or additional investments in facility support for quality improvement could be prioritized.

Indexed as

MedicarePatient ReadmissionSkilled Nursing FacilitiesValue-Based PurchasingCross-Sectional StudiesHumansReimbursement, IncentiveRetrospective StudiesUnited Stateshealth policyMedicarereadmissionsskilled nursing facility

Identifiers

PMID40751494
PMCPMC13175677

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.