CMS Releases New Data on Medicare Advantage Beneficiaries’ Use of Skilled Nursing   

In 2019, there were about 46.6 skilled nursing facility stays per 1,000 Medicare Advantage beneficiaries on a national basis.

That’s according to data released Monday by the Centers for Medicare & Medicaid Services (CMS), on the utilization of skilled nursing facilities among beneficiaries enrolled in Medicare Advantage plans.

The data also showed there were about 945 SNF days per 1,000 Medicare Advantage beneficiaries on a national basis in 2019.

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The federal agency shares public use files (PUF) from time to time to support timely benefit and rate analysis for researchers and other stakeholders, and the latest information pertains to state-by-state variations in use of Medicare Advantage plans within SNFs. This latest data also includes metrics on SNF utilization and beneficiary demographic characteristics for Medicare beneficiaries. The data shared covers calendar years 2016 through 2019.

Of the data sets shared, the Medicare Advantage Geographic Variation National & State data set provides contains information on demographic characteristics and service utilization for hospital inpatient and skilled nursing facility services for Medicare Advantage beneficiaries at the national and state levels for Medicare beneficiaries who were enrolled in MA for the full year.  

Meanwhile, CMS also updated information in CMS Program Statistics (CPS) tables to include more detailed reports on several other metrics related to Medicare Advantage within SNFs. These reports contain trend, demographic, and state tables with skilled nursing facility utilization for beneficiaries enrolled in MA plans. The data also spans calendar years 2016 through 2019.

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The data reflects the growth of Medicare Advantage enrollment in those years, with about 18.35 million total MA Part A enrollees in 2016 and 22.9 million total MA Part A enrollees in 2019.

Total SNF admissions among this population increased from 865,190 in 2016 to about 1.2 million in 2019.

In 2019, about 15.5 million MA Part A enrollees were identified as “Non-Hispanic White,” making up the largest demographic group of enrollees, according to the algorithm developed by the Research Triangle Institute. “Hispanic” enrollees numbered about 3.13 million and “Black (or African American)” enrollees numbered about 2.9 million. However, Black (or African American) enrollees accounted for 14.5% of total SNF admissions while Hispanic enrollees accounted for 7.7%.

In calendar year 2019, Florida was the state that had the most total SNF admissions among its population of Medicare Advantage Part A beneficiaries, with 109,389.

With about 2.1 million MA Part A beneficiaries, Florida trailed only California for total number of enrollees, as the Golden State had roughly 2.74 million beneficiaries. But California had only 26.63 SNF admissions per 1,000 MA Part A enrollees, compared with 52.08 admissions per 1,000 MA Part A enrollees in Florida.

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