Vertical Integration Into Skilled Nursing Facilities and Hospital Readmission Rates

Tory H. Hogan, Christy Harris Lemak, Larry R. Hearld, Jack Wheeler, Bisakha Pia Sen, Nir Menachemi

Research output: Contribution to journalArticlepeer-review


Following the Affordable Care Act (ACA), more hospitals vertically integrated into skilled nursing facilities (SNFs). Hospitals are now being penalized for avoidable readmissions, creating a greater demand for better coordination of care between hospitals and SNF. We created a longitudinal panel data set by merging data from the American Hospital Association's Annual Survey, CMS' Hospital Compare, and the Rural Urban Commuting Area data. Hospital and year fixed-effects models were used to examine the relationship between hospital vertical integration into SNF and 30-day pneumonia and heart failure (HF) readmission rates between 2008 and 2011. Our primary analyses modeled the impact of hospital vertical integration into SNF on 30-day readmissions for both pneumonia and HF using hospital and year fixed effects. Our secondary analyses examined whether hospital vertical integration into SNF was associated with a change in readmissions rates among different types of hospitals. Our results indicate that hospitals that vertically integrated into SNF were associated with a reduction in hospital 30-day pneumonia readmission rates (β = -0.233, p = .039). Vertical integration into SNF was not significantly associated with 30-day HF readmissions. Our secondary analyses found variation in the impact of vertical integration on readmission rates among different hospital organizational types.

Original languageEnglish (US)
Pages (from-to)91-97
Number of pages7
JournalJournal for healthcare quality : official publication of the National Association for Healthcare Quality
Issue number2
StatePublished - Mar 1 2020

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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