For skilled nursing facilities, this evidence suggests that ACO network participation may generate stronger referral pipelines to higher-rated facilities than Medicare Advantage plan alignment, given MA’s demonstrated pattern of directing patients toward lower-quality providers.
“Consistently, ACO-attributed beneficiaries were the most likely, while MA enrollees were the least likely to enter high-quality SNFs, regardless of dementia diagnosis. Our findings highlight significant differences in access to high-quality SNFs across Medicare payment models, with ACO-attributed beneficiaries consistently experiencing better access than their MA or traditional Medicare counterparts.”
— Journal of the American Geriatrics Society, 31 December 2024
Wang, Huiying, et al. “Do Medicare Beneficiaries Under Accountable Care or Medicare Advantage Use Lower Quality Nursing Homes?” Journal of the American Geriatrics Society, 31 December 2024. https://doi.org/10.1111/jgs.19328
ACO Beneficiaries Most Likely to Land in High-Quality Nursing Homes
“MA networks might have lower quality SNFs compared to other networks, and second of all, they’re trying to steer the patients to lower-quality SNFs intentionally,” said Wang. “And third, MA enrollees have some overwhelming decisions to make. There are so many MA plans.”
— McKnight’s Long-Term Care News, 3 January 2025
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