Medicaid Support Program Had Little Effect on Nursing Home Quality

An analysis of nursing homes in three states that implemented Medicaid Managed Long-Term Services and Supports (MLTSS) identified few improvements in nursing home quality and rebalancing resulting from the program, according to study results published online ahead of print in Health Services Research. 

“The study provides little evidence that MLTSS reduces quality of care, occupancy, or the percentage of low-care residents in nursing homes,” researchers wrote. 

The study used secondary data from annual nursing home recertification surveys as well Minimum Data Set information for a difference-in-difference analysis of nursing homes in border counties of three states that implemented MLTSS: Massachusetts (2001-2007), Kansas (2011-2017), and Ohio (2011-2017). MLTSS nursing homes were also compared with a control group of nursing homes in neighboring border counties in states that did not implement MLTSS. Researchers were interested in six outcomes: percentage of low-care residents, facility occupancy, and four quality measures. 

According to the study, NH quality outcomes were not significantly changed by MLTSS in Massachusetts or Kansas, while Ohio had an increase of 0.21 nursing hours per resident day and a decrease of 1.47 deficiencies and 9.38 deficiency points per certification survey. 

Facility occupancy decreased 1.52 percentage points in Massachusetts after MLTSS, the study showed. However, Ohio showed an occupancy increase of 3.17 percentage points with MLTSS. 

The percentage of low-care residents in all three states was unchanged.  

“Findings were moderately sensitive to the choice of comparator group,” researchers noted. 

Reference

Potter AJ, Bowblis JR. Nursing home care under Medicaid managed long-term services and supports [published online ahead of print, 2021 Jul 14]. Health Serv Res. 2021;10.1111/1475-6773.13701. doi:10.1111/1475-6773.13701