Size of the Financial Incentives in Medicare’s Skilled Nursing Facility Value-Based Purchasing Program

What were the size and scope of the financial bonuses or penalties received by skilled nursing facilities (SNFs) in the first 3 years of the SNF Value-Based Purchasing (VBP) program?In this cohort study of more than 5 million qualifying SNF stays in 14 189 SNFs, the median reimbursement adjustment across all SNFs and years was −$10 336, or 0.15% of average SNF operating income. In addition, the financial incentives were highly variable from year to year for most SNFs.These findings suggest that the small size and high variability of incentives may have contributed to the relative lack of effectiveness of the SNF VBP program.

Corresponding Author: Robert E. Burke, MD, MS, Division of Hospital Medicine, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr, 1232 Blockley Hall, Philadelphia, PA 19104 (robert.burke2@pennmedicine.upenn.edu).

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