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Institutional Special Needs Plans could be the tool nursing homes need to find better clinical and financial success and help the government achieve its goals of reducing costs and improving quality, a trio of researchers and policy advisors argues in the New England Journal of Medicine.
But more data is needed to determine whether the plans are generating the kinds of outcomes that the Centers for Medicare & Medicaid Services is pushing for in its other value-based care payment models.
I-SNPs have grown both in the number of plans and in resident enrollment, surpassing 100,000 beneficiaries in 2023. Nursing home participation is often seen as a defensive maneuver, given that the plans can be an alternative to other, lower paying Medicare Advantage plans.
Despite the clinical add-ons provided by plans — most notably nurse practitioners, specialist support and supplemental benefits — it’s currently hard to measure their impact because of misaligned ratings information, the researchers wrote in an Aug. 31 perspective.