[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-426685-105":59,"doc-detail-426685-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","nursing-homes-as-insurers-the-effect-of-provider-led-institutional-special-needs-plans-abstract","NURSING HOMES AS INSURERS? THE EFFECT OF PROVIDER-LED INSTITUTIONAL SPECIAL NEEDS PLANS - Abstract","","Institutional Special Needs Plans (I-SNPs) enable Medicare Advantage insurers to tailor benefits for long-term nursing home residents. Provider-led I-SNPs, introduced in the mid-2000s, evolved as nursing homes entered the market and plans varied by risk responsibility. Using a difference-in-differences design with Medicare claims and Minimum Data Set assessments from 2004-2021, the study finds provider-led I-SNPs increase I-SNP enrollment by 17.0 percentage points within four years versus controls and change utilization patterns. Hospitalizations decline while hypnotic drug use and pressure ulcer reporting rise, indicating potential utilization reduction with ambiguous quality and competition effects.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/nursing-homes-as-insurers-the-effect-of-provider-led-institutional-special-needs-plans-abstract/426685/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/nursing-homes-as-insurers-the-effect-of-provider-led-institutional-special-needs-plans-abstract/426685.png","ImageObject",300,407,{"name":92,"@type":93},"Blue Pony","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-20","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What are Institutional Special Needs Plans (I-SNPs) in Medicare Advantage?","Question",{"text":112,"@type":113},"I-SNPs are Medicare Advantage plans that let insurers differentiate benefits specifically for long-term nursing home residents.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the study measure the impact of provider-led I-SNPs?",{"text":117,"@type":113},"It used a difference-in-differences design with Medicare claims and Minimum Data Set resident assessments from 2004 to 2021.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main findings on enrollment and quality-related outcomes?",{"text":121,"@type":113},"Provider-led I-SNPs increased I-SNP enrollment by 17.0 percentage points within four years, decreased hospitalizations, and increased hypnotic drug use and pressure ulcer reporting.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},426685,1790989333,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81},962090760266,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Innovation in Aging, 2025, Vol. 9, No. S2 301  \nInstitutional Special Needs Plans (I-SNPs) are a type of Medicare Advantage (MA) plan that allow insurers in MA to differentiate their benefits exclusively for long-term residents of nursing homes. When I-SNPs were first offered in 2006, the early I-SNP models were insurer-led as the plan was primarily at-risk for long-stay residents’ Medicare spending. Today however, nursing homes have increasingly been entering the I-SNP market with I-SNP models differentiated based on the level of risk borne by the insurer and nursing home. We use a difference-in-differences design to estimate the effect of offering a provider-led I-SNP on enrollment and quality of care. Using Medicare claims and the Minimum Data Set resident assessments from 2004-2021, we find that offering a provider-led I-SNP led to a 17.0 percentage point increase in I-SNP enrollment among facility residents within four years relative to control nursing homes. We also estimate that offering provider-led I-SNPs significantly decreased hospitalizations and increased the use of hypnotic drugs and reporting of pressure ulcers by nursing homes. Relative to the baseline mean among treated nursing homes, we found relative declines of 18.2% for hospitalizations and increases of 30.3% for hypnotic drug use and 15.6% for pressure ulcers. These results suggest that risk bearing by nursing homes in the form of provider-led I-SNPs may successfully reduce utilization, but with unclear implications for quality and competition.  \nAbstract citation ID: igaf122.1015  \nNURSING HOMES AS INSURERS? THE EFFECT OF  \nPROVIDER-LED INSTITUTIONAL SPECIAL  \nNEEDS PLANS  \nAmanda Chen1, and David Grabowski2, 1. University of Southern California, Los Angeles, California, United States, 2. Harvard University, Cambridge, Massachusetts, United States","cbCaimeIV1k85za6","https://ap.wps.com/l/cbCaimeIV1k85za6","pdf",313414,"English","# Study objective\n# Methods and data\n# Enrollment and utilization effects\n## Hospitalizations\n## Hypnotic drug use\n## Pressure ulcers\n# Interpretation and implications","[{\"question\":\"What are Institutional Special Needs Plans (I-SNPs) in Medicare Advantage?\",\"answer\":\"I-SNPs are Medicare Advantage plans that let insurers differentiate benefits specifically for long-term nursing home residents.\"},{\"question\":\"How did the study measure the impact of provider-led I-SNPs?\",\"answer\":\"It used a difference-in-differences design with Medicare claims and Minimum Data Set resident assessments from 2004 to 2021.\"},{\"question\":\"What were the main findings on enrollment and quality-related outcomes?\",\"answer\":\"Provider-led I-SNPs increased I-SNP enrollment by 17.0 percentage points within four years, decreased hospitalizations, and increased hypnotic drug use and pressure ulcer reporting.\"}]","NURSING HOMES AS INSURERS? THE EFFECT OF PROVIDER-LED INSTITUTIONAL SPECIAL NEEDS PLANS - Abstract | PDF",1790641438]