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Study Finds I-SNP Engagement Linked to Increased Hospice Utilization in Nursing Homes with 50 or More Beds

A study led by the MJHS Institute for Innovation in Palliative Care in collaboration with LeadingAge NY has found that nursing home engagement with Institutional Special Needs Plans (I-SNPs) is associated with increased hospice enrollment, except in small nursing homes. The study, which is the first to examine the relationship between I-SNPs and hospice utilization in nursing homes, evaluated national data from 2011 and 2013 and found that I-SNP engagement in nursing homes—measured as the proportion of nursing homes with at least one enrollee every month —was positively associated with percentage hospice enrollment, except in nursing homes with under 50 beds, where the opposite relationship was observed.

I-SNPs are a type of Medicare Advantage plan that serve a growing number of nursing home residents. Ideally, I-SNPs should help residents to obtain access to the hospice benefit for care at the end of life. Until now, the relationship between I-SNP enrollment and access to hospice had not been analyzed, and some observers were concerned that I-SNP penetration might suppress hospice enrollment. According to Dr. Lara Dhingra, MJHS's principal investigator on the study, "The findings suggest that I-SNPs and hospice may be working together in most nursing homes that offer their residents both types of programs. Efforts are needed to promote this coordination and ensure that it occurs in every nursing home.”

More research is needed to understand the nature of the relationship between I-SNPs and hospice and whether specific efforts are needed to improve coordination between the two programs, particularly in smaller nursing homes.

The study, which was published in the Journal of the American Geriatrics Society, is available here.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8383 ext. 124