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Trends In Hospitals And Skilled Nursing Facilities Sharing Medical Providers, 2008–16: Study examines the extent to which hospitals and nursing homes share physicians and advanced practice clinicians.
Open accessAbstract
Hospitals and skilled nursing facilities (SNFs) face increasing pressure to improve care coordination and reduce unnecessary readmissions. One strategy to accomplish this is to share physicians and advanced practice clinicians, so that the same providers see patients in both settings. Using 2008-16 Medicare claims, we found that as SNFs moved increasingly toward using SNF specialists, there was a steady decline in the number of facilities sharing medical providers and in the proportion of SNF primary care delivered by provider practices with both hospital and SNF clinicians (hospital-SNF practices). In SNF fixed effects analyses, we found that SNFs that increased primary care visits by hospital-SNF practices had slightly fewer readmissions, shorter lengths-of-stay, and increased successful community discharges. These findings suggest that SNFs that share medical providers with hospitals may see some benefit from that linkage, although the magnitude of the benefit may be small.
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“An analysis of Medicare claims data for 2008 to 2016 showed that skilled nursing facilities that shared providers with at least one hospital were more likely to have an Alzheimer unit, had fewer 30-day readmissions and had more patients successfully discharged to the community.796”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [796]
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“had more patients successfully discharged to the community”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [956]
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“had fewer 30‐day readmissions”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [956]
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“The skilled nursing facilities that maintain these relationships have modestly better outcomes, 956”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [956]
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“skilled nursing facilities that shared providers with at least one hospital were more likely to have an Alzheimer's unit”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [956]
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The Residential History File: Studying Nursing Home Residents' Long‐Term Care Histories*
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Self-citationGrowth in the Care of Older Patients by Hospitalists in the United States
Kuo, Y., Sharma, G., Freeman, J. L., & Goodwin, J. S. (2009) · New England Journal of Medicine · doi:10.1056/nejmsa0802381 · Cited by 240
Physician Consolidation: Rapid Movement From Small To Large Group Practices, 2013–15
Muhlestein, D. B., & Smith, N. J. (2016) · Health Affairs · doi:10.1377/hlthaff.2016.0130 · Cited by 118
Effect of Hospital– SNF Referral Linkages on Rehospitalization
Rahman, M., Foster, A., Grabowski, D. C., Zinn, J. S., & Mor, V. (2013) · Health Services Research · doi:10.1111/1475-6773.12112 · Cited by 101
Self-citationZhu, J. M., Patel, V., Shea, J. A., Neuman, M. D., & Werner, R. M. (2018) · Health Affairs · doi:10.1377/hlthaff.2018.0257 · Cited by 80
Katz, P. R., Karuza, J., Kolassa, J. E., & Hutson, A. D. (1997) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1997.tb02958.x · Cited by 77
Konetzka, R. T., Stuart, E. A., & Werner, R. M. (2016) · Journal of Health Economics · doi:10.1016/j.jhealeco.2018.01.005 · Cited by 69
Reducing Hospital Readmissions Through Preferred Networks Of Skilled Nursing Facilities
McHugh, J., Foster, A., Mor, V., Shield, R. R., Trivedi, A. N., Wetle, T. T., Zinn, J. S., & Tyler, D. (2017) · Health Affairs · doi:10.1377/hlthaff.2017.0211 · Cited by 66
Self-citationWinblad, U., Mor, V., McHugh, J., & Rahman, M. (2017) · Health Affairs · doi:10.1377/hlthaff.2016.0759 · Cited by 63
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Research works printed but not linked: 1
- O’Donnell B, MedPAC Public Meeting
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2023 Alzheimer's disease facts and figures
(2023) · Alzheimer's & Dementia · doi:10.1002/alz.13016 · Cited by 3,212
2024 Alzheimer's disease facts and figures
(2024) · Alzheimer's & Dementia · doi:10.1002/alz.13809 · Cited by 2,536
2022 Alzheimer's disease facts and figures
Anonymous (2022) · Alzheimer s & Dementia · doi:10.1002/alz.12638 · Cited by 2,469
2025 Alzheimer's disease facts and figures
(2025) · Alzheimer s & Dementia · doi:10.1002/alz.70235 · Cited by 642
2026 Alzheimer's disease facts and figures
(2026) · Alzheimer s & Dementia · doi:10.1002/alz.71345 · Cited by 69
Block, L., Hovanes, M., & Gilmore‐Bykovskyi, A. L. (2022) · Geriatric Nursing · doi:10.1016/j.gerinurse.2022.04.010 · Cited by 6
Hospital utilization by older and younger patients in Canada: pre-pandemic findings
Wilson, D. M., Zhou, Y., Bolaji-Osagie, S., Bryenton, F. M., Dou, Q., & Low, G. (2024) · Journal of Public Health Policy · doi:10.1057/s41271-024-00520-2 · Cited by 4
How Benchmark Changes Affect Participation in Accountable Care Organizations
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Riester, M. R., Douglas, C. M., Silva, J. B. B., Datta, R., & Zullo, A. R. (2023) · Antimicrobial Stewardship & Healthcare Epidemiology · doi:10.1017/ash.2023.527 · Cited by 2
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Approaches to Identify Nursing Home Specialists Using Medicare Claims Data
Riester, M. R., Ryskina, K. L., White, E. M., Hayes, K. N., Harris, D. A., & Zullo, A. R. (2025) · Medical Care · doi:10.1097/mlr.0000000000002161 · Cited by 1
Self-citationWu, J., Lu, Z. K., & Davis–Ajami, M. L. (2026) · BMC Health Services Research · doi:10.1186/s12913-026-14601-3
Metadata
- Authors
- White, E. M., Kosar, C. M., Rahman, M., & Mor, V.
- Affiliations
- Brown University (US)
- Venue
- Health Affairs
- Publisher
- Health Affairs Publishing, LLC
- Published
- 2020-08-01
- Volume
- 39
- Issue
- 8
- Pages
- 1312-1320
- ISSN
- 0278-2715 (ISSN-L)
- 1544-5208
- PMC
- PMC7446141
- OpenAlex
- W3046560127
- Cited by
- 12
- References
- 22
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 2
- FWCI
- 1.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Health Affairs (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (2p01ag027296-16)
- Agency for Healthcare Research and Quality (T32HS000011)
- National Institute on Aging (P01AG-027296)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Nursing › Leadership and Management › Hospital Admissions and Outcomes
- Keywords
- skilled nursing facilities, hospitals, care coordination, hospital readmission, primary care, community discharge, length of hospital stay, Medicare, advanced practitioners
- MeSH terms
- Aged, Medicare, Hospitals, Humans, Patient Discharge, Physicians, Skilled Nursing Facilities, Specialization, United States
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