Variation in the Utilization of the Medicare Skilled Nursing Facility Benefit
Data from July 1984 through June 1985 were used to study the Medicare skilled nursing facility (SNF) benefit. Two modeling approaches analyze the variation in utilization. A market-level model examines variation across metropolitan areas; the second approach is patient-level analysis. Findings from both analyses are generally consistent. Patients were more likely to use SNF care if they were discharged from hospitals in areas that had larger supplies of Medicare-certified SNF beds, had more SNF beds located in hospitals, had higher per capita income, were in states with high SNF use, and were in states with low Medicaid SNF utilization. Medical practice patterns at the state, metropolitan, and hospital level were all found to have distinguishable effects on the probability that a patient would receive SNF services.