Medicare patients with opioid use disorder are less likely to be admitted to highly rated skilled nursing home facilities, a new study finds.
Investigators from Brown University conducted the study to investigate whether there were any discrepancies in admissions practices of skilled nursing facilities for patients with opioid use disorder issues.
The nationwide, retrospective observational cohort included 30,922 Medicare patients with opioid use disorder and 137,444 patients without OUD, who were admitted to skilled nursing facilities following hospitalization. The median age of the patients studied was 71.
Several previous studies and an OIG report issued late last year have shown the number of seniors affected by opioid dependency is growing, while access to treatment for Medicare beneficiaries persists.
“I approach this work as how we can provide more support for SNFs to provide care for this population,” lead author Patience Moyo Dow, PhD, told McKnight’s Long-Term Care News. “There should not be a point where these people fall through the cracks in their treatment. This is not to say SNFs should become treatment facilities, but we need to be able to treat these people who are coming into these facilities for care.”
The research team used data, including Centers for Medicare & Medicaid Services star ratings, to compare the quality of the facilities that patients in the different groups were sent to, Dow explained.
In general, the study found patients with opioid use disorder were more likely to be admitted to lower-rated skilled nursing facilities, based on the CMS star ratings the facilities received.
“Despite mixed results on component ratings, our findings suggest a concerning disparity in the overall quality of SNFs admitting Medicare beneficiaries with OUD,” the study’s authors wrote. “Enhancing equitable access to high-quality SNF care for individuals with OUD is imperative amid rising demand and legal protections under the American Disabilities Act.”
Dow said the study’s results suggest patients with OUD are more likely to face barriers to admission to highly rated skilled nursing facilities, perhaps due to stigma or discrimination surrounding opioid use, reimbursement issues or other factors.
“Truly, the long-term goal is to improve equity,” she said. “There is some evidence that these patients are facing barriers. We want to improve that access.”
Dow hopes their study will lead to further research on how policy makers and nursing home leaders can improve access to care for these patients, including the potential for increased funding for facilities that accept patients with OUD issues and more education on the effectiveness of drug treatment medications such as methadone.
