Increasing Prevalence of Assisted Living as a Substitute for Private‐Pay Long‐Term Nursing Care

Objective Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long‐term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county‐level AL beds on the prevalence of private...

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Published in:	Health services research Vol. 53; no. 6; pp. 4906 - 4920
Main Authors:	Silver, Benjamin C., Grabowski, David C., Gozalo, Pedro L., Dosa, David, Thomas, Kali S.
Format:	Journal Article
Language:	English
Published:	United States Health Research and Educational Trust 01.12.2018 Blackwell Publishing Ltd John Wiley and Sons Inc
Subjects:	Aged Aged, 80 and over Analysis Assisted living Assisted living facilities Assisted Living Facilities - statistics & numerical data Censuses Counties Enrollments Health Expenditures - statistics & numerical data Health services Humans Insurance Claim Review Length of residency Long term care Long term health care Long-term care of the sick Markets Medicaid - economics Medicare Medicare - economics Medicare - statistics & numerical data nursing home Nursing homes Nursing Homes - statistics & numerical data Prevalence Residents Retrospective Studies Services Skilled Nursing Care, Quality, and Cost Studies United States United States New Hampshire nursing home long-term care Assisted living
ISSN:	0017-9124, 1475-6773, 1475-6773
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Abstract	Objective Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long‐term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county‐level AL beds on the prevalence of private‐pay residents and private‐pay resident days at the NH‐level. Data Sources National census of large AL providers (25+ beds), and Minimum Data Set combined with Medicare enrollment records and claims from 2007 and 2014. Study Design Retrospective longitudinal analysis of LTC markets. Principal Findings Mean AL beds per county increased from 285 to 324, while NHs exhibited a decrease in private‐pay residents (20.1 to 17.7 percent) and resident days (21.3 to 17.5 percent). An increase of 1,000 AL beds at the county level is associated with a reduction of 0.44 percentage points in private‐pay resident days but is not significantly associated with percent of private‐pay residents. Conclusions These results suggest that increases in AL capacity have potentially allowed NH residents to delay or decrease their privately financed lengths of stay. As demand for AL continues to grow, it will be important to assess the effects on other LTC sectors.
AbstractList	Objective. Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long-term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county-level AL beds on the prevalence of private-pay residents and private-pay resident days at the NH-level. Data Sources. National census of large AL providers (25+ beds), and Minimum Data Set combined with Medicare enrollment records and claims from 2007 and 2014. Study Design. Retrospective longitudinal analysis of LTC markets. Principal Findings. Mean AL beds per county increased from 285 to 324, while NHs exhibited a decrease in private-pay residents (20.1 to 17.7 percent) and resident days (21.3 to 17.5 percent). An increase of 1,000 AL beds at the county level is associated with a reduction of 0.44 percentage points in private-pay resident days but is not significandy associated with percent of private-pay residents. Conclusions. These results suggest that increases in AL capacity have potentially allowed NH residents to delay or decrease their privately financed lengths of stay. As demand for AL continues to grow, it will be important to assess the effects on other LTC sectors. Key Words. Assisted living, nursing home, long-term care Principal Findings. Mean AL beds per county increased from 285 to 324, while NHs exhibited a decrease in private-pay residents (20.1 to 17.7 percent) and resident days (21.3 to 17.5 percent). An increase of 1,000 AL beds at the county level is associated with a reduction of 0.44 percentage points in private-pay resident days but is not significandy associated with percent of private-pay residents. Objective Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long‐term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county‐level AL beds on the prevalence of private‐pay residents and private‐pay resident days at the NH‐level. Data Sources National census of large AL providers (25+ beds), and Minimum Data Set combined with Medicare enrollment records and claims from 2007 and 2014. Study Design Retrospective longitudinal analysis of LTC markets. Principal Findings Mean AL beds per county increased from 285 to 324, while NHs exhibited a decrease in private‐pay residents (20.1 to 17.7 percent) and resident days (21.3 to 17.5 percent). An increase of 1,000 AL beds at the county level is associated with a reduction of 0.44 percentage points in private‐pay resident days but is not significantly associated with percent of private‐pay residents. Conclusions These results suggest that increases in AL capacity have potentially allowed NH residents to delay or decrease their privately financed lengths of stay. As demand for AL continues to grow, it will be important to assess the effects on other LTC sectors. Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long-term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county-level AL beds on the prevalence of private-pay residents and private-pay resident days at the NH-level. National census of large AL providers (25+ beds), and Minimum Data Set combined with Medicare enrollment records and claims from 2007 and 2014. Retrospective longitudinal analysis of LTC markets. Mean AL beds per county increased from 285 to 324, while NHs exhibited a decrease in private-pay residents (20.1 to 17.7 percent) and resident days (21.3 to 17.5 percent). An increase of 1,000 AL beds at the county level is associated with a reduction of 0.44 percentage points in private-pay resident days but is not significantly associated with percent of private-pay residents. These results suggest that increases in AL capacity have potentially allowed NH residents to delay or decrease their privately financed lengths of stay. As demand for AL continues to grow, it will be important to assess the effects on other LTC sectors. ObjectiveGiven the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long‐term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county‐level AL beds on the prevalence of private‐pay residents and private‐pay resident days at the NH‐level.Data SourcesNational census of large AL providers (25+ beds), and Minimum Data Set combined with Medicare enrollment records and claims from 2007 and 2014.Study DesignRetrospective longitudinal analysis of LTC markets.Principal FindingsMean AL beds per county increased from 285 to 324, while NHs exhibited a decrease in private‐pay residents (20.1 to 17.7 percent) and resident days (21.3 to 17.5 percent). An increase of 1,000 AL beds at the county level is associated with a reduction of 0.44 percentage points in private‐pay resident days but is not significantly associated with percent of private‐pay residents.ConclusionsThese results suggest that increases in AL capacity have potentially allowed NH residents to delay or decrease their privately financed lengths of stay. As demand for AL continues to grow, it will be important to assess the effects on other LTC sectors. Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long-term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county-level AL beds on the prevalence of private-pay residents and private-pay resident days at the NH-level.OBJECTIVEGiven the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long-term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county-level AL beds on the prevalence of private-pay residents and private-pay resident days at the NH-level.National census of large AL providers (25+ beds), and Minimum Data Set combined with Medicare enrollment records and claims from 2007 and 2014.DATA SOURCESNational census of large AL providers (25+ beds), and Minimum Data Set combined with Medicare enrollment records and claims from 2007 and 2014.Retrospective longitudinal analysis of LTC markets.STUDY DESIGNRetrospective longitudinal analysis of LTC markets.Mean AL beds per county increased from 285 to 324, while NHs exhibited a decrease in private-pay residents (20.1 to 17.7 percent) and resident days (21.3 to 17.5 percent). An increase of 1,000 AL beds at the county level is associated with a reduction of 0.44 percentage points in private-pay resident days but is not significantly associated with percent of private-pay residents.PRINCIPAL FINDINGSMean AL beds per county increased from 285 to 324, while NHs exhibited a decrease in private-pay residents (20.1 to 17.7 percent) and resident days (21.3 to 17.5 percent). An increase of 1,000 AL beds at the county level is associated with a reduction of 0.44 percentage points in private-pay resident days but is not significantly associated with percent of private-pay residents.These results suggest that increases in AL capacity have potentially allowed NH residents to delay or decrease their privately financed lengths of stay. As demand for AL continues to grow, it will be important to assess the effects on other LTC sectors.CONCLUSIONSThese results suggest that increases in AL capacity have potentially allowed NH residents to delay or decrease their privately financed lengths of stay. As demand for AL continues to grow, it will be important to assess the effects on other LTC sectors.
Audience	Trade
Author	Silver, Benjamin C. Grabowski, David C. Gozalo, Pedro L. Thomas, Kali S. Dosa, David
AuthorAffiliation	1 Health Care Financing and Payment RTI International Waltham MA 2 Brown University School of Public Health Providence RI 4 Department of Veterans Affairs Medical Center Providence RI 3 Department of Health Care Policy Harvard Medical School Boston MA
AuthorAffiliation_xml	– name: 4 Department of Veterans Affairs Medical Center Providence RI – name: 2 Brown University School of Public Health Providence RI – name: 3 Department of Health Care Policy Harvard Medical School Boston MA – name: 1 Health Care Financing and Payment RTI International Waltham MA
Author_xml	– sequence: 1 givenname: Benjamin C. orcidid: 0000-0001-6941-3733 surname: Silver fullname: Silver, Benjamin C. organization: Brown University School of Public Health – sequence: 2 givenname: David C. surname: Grabowski fullname: Grabowski, David C. organization: Harvard Medical School – sequence: 3 givenname: Pedro L. surname: Gozalo fullname: Gozalo, Pedro L. organization: Brown University School of Public Health – sequence: 4 givenname: David surname: Dosa fullname: Dosa, David organization: Department of Veterans Affairs Medical Center – sequence: 5 givenname: Kali S. surname: Thomas fullname: Thomas, Kali S. email: Kali_Thomas@brown.edu organization: Department of Veterans Affairs Medical Center
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/30066481$$D View this record in MEDLINE/PubMed
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References	2011 2010; 29 2004; 39 2015; 53 2004; 23 2013; 53 2017; 56 1998 2005; 40 2011; 30 2008; 45 2017 2011; 46 2016 2011; 78 2013 2014; 9 2012; 47 2018; 56 2016; 38 2008; 90 1996; 31 2003; 43 2003; 22 e_1_2_7_6_1 e_1_2_7_5_1 Harris‐Kojetin L. (e_1_2_7_16_1) 2016; 38 e_1_2_7_9_1 Wiener J. M. (e_1_2_7_29_1) 2013 e_1_2_7_8_1 e_1_2_7_7_1 e_1_2_7_19_1 Thomas K. S. (e_1_2_7_27_1) 2017; 56 e_1_2_7_18_1 Khatutsky G. (e_1_2_7_20_1) 2016 e_1_2_7_17_1 e_1_2_7_13_1 e_1_2_7_12_1 e_1_2_7_11_1 e_1_2_7_10_1 e_1_2_7_26_1 e_1_2_7_28_1 Park‐Lee E. (e_1_2_7_22_1) 2011; 78 Banaszak‐Holl J. (e_1_2_7_4_1) 1996; 31 Assisted Living Quality Coalition (e_1_2_7_3_1) 1998 AARP Public Policy Institute (e_1_2_7_2_1) 2017 e_1_2_7_25_1 e_1_2_7_24_1 e_1_2_7_23_1 e_1_2_7_21_1 Hagen S. A. (e_1_2_7_14_1) 2013 Harris‐Kojetin L. (e_1_2_7_15_1) 2013
References_xml	– year: 2011 – volume: 78 start-page: 1 year: 2011 end-page: 8 article-title: Residential Care Facilities: A Key Sector in the Spectrum of Long‐Term Care Providers in the United States publication-title: NCHS Data Brief – volume: 38 start-page: 1 year: 2016 end-page: 118 article-title: Long‐Term Care Providers and Services Users in the United States: Data from the National Study of Long‐Term Care Providers, 2013–2014 publication-title: Vital & Health Statistics Series 3, Analytical and Epidemiological Studies – volume: 9 start-page: 95 issue: 1 year: 2014 end-page: 112 article-title: Nursing Home Prices and Market Structure: The Effect of Assisted Living Industry Expansion publication-title: Health Economics, Policy and Law – volume: 46 start-page: 120 issue: 1 Pt 1 year: 2011 end-page: 37 article-title: The Residential History File: Studying Nursing Home Residents’ Long‐Term Care Histories publication-title: Health Services Research – volume: 40 start-page: 373 issue: 2 year: 2005 end-page: 88 article-title: Medicare Expenditures for Residents in Assisted Living: Data from a National Study publication-title: Health Services Research – volume: 29 start-page: 35 issue: 1 year: 2010 end-page: 43 article-title: Sizing Up the Market for Assisted Living publication-title: Health Affairs – volume: 22 start-page: 1 issue: 1 year: 2003 end-page: 22 article-title: Competitive Spillovers across Non‐Profit and For‐Profit Nursing Homes publication-title: Journal of Health Economics – volume: 39 start-page: 463 issue: 3 year: 2004 end-page: 88 article-title: Effects of Medicare Payment Changes on Nursing Home Staffing and Deficiencies publication-title: Health Services Research – volume: 43 start-page: 875 issue: 6 year: 2003 end-page: 82 article-title: A National Survey of Assisted Living Facilities publication-title: Gerontologist – volume: 56 start-page: e10 year: 2018 end-page: 5 article-title: A Methodology to Identify a Cohort of Medicare Beneficiaries Residing in Large Assisted Living Facilities Using Administrative Data publication-title: Medical Care – year: 2016 – volume: 31 start-page: 650 year: 1996 end-page: 76 article-title: Does Publicly Provided Home Care Substitute for Family Care? Experimental Evidence with Endogenous Living Arrangements publication-title: Journal of Human Resources – year: 1998 – volume: 45 start-page: 58 issue: 1 year: 2008 end-page: 74 article-title: The Market for Long‐Term Care Services publication-title: Inquiry: The Journal of Health Care Organization, Provision, and Financing – volume: 53 start-page: 574 issue: 7 year: 2015 article-title: The Impact of Medicaid Payer Status on Hospitalizations in Nursing Homes publication-title: Medical Care – volume: 31 start-page: 97 issue: 1 year: 1996 article-title: The Impact of Market and Organizational Characteristics on Nursing Care Facility Service Innovation: A Resource Dependency Perspective publication-title: Health Services Research – volume: 29 start-page: 11 issue: 1 year: 2010 end-page: 21 article-title: Long‐Term Care: Who Gets it, Who Provides it, Who Pays, and How Much? publication-title: Health Affairs – start-page: 1 issue: 37 year: 2013 end-page: 107 article-title: Long‐Term Care Services in the United States: 2013 Overview publication-title: Vital & Health Statistics Series 3, Analytical and Epidemiological Studies – volume: 30 start-page: 719 issue: 4 year: 2011 end-page: 29 article-title: Income and the Utilization of Long‐Term Care Services: Evidence from the Social Security Benefit Notch publication-title: Journal of Health Economics – volume: 23 start-page: 243 issue: 5 year: 2004 end-page: 52 article-title: Medicaid Payment and Risk‐Adjusted Nursing Home Quality Measures publication-title: Health Affairs – volume: 53 start-page: 211 issue: 2 year: 2013 end-page: 21 article-title: The Relationships Among Licensed Nurse Turnover, Retention, and Rehospitalization of Nursing Home Residents publication-title: Gerontologist – year: 2017 – volume: 47 start-page: 2296 issue: 6 year: 2012 end-page: 315 article-title: Assisted Living Expansion and the Market for Nursing Home Care publication-title: Health Services Research – volume: 90 start-page: 754 issue: 4 year: 2008 end-page: 64 article-title: Nursing Home Quality as a Common Good publication-title: The Review of Economics and Statistics – volume: 56 start-page: e26 issue: 5 year: 2017 end-page: 31 article-title: Constructing a Measure of Private‐Pay Nursing Home Days publication-title: Medical Care – year: 2013 – volume: 31 start-page: 97 issue: 1 year: 1996 ident: e_1_2_7_4_1 article-title: The Impact of Market and Organizational Characteristics on Nursing Care Facility Service Innovation: A Resource Dependency Perspective publication-title: Health Services Research – ident: e_1_2_7_17_1 doi: 10.1093/geront/43.6.875 – ident: e_1_2_7_9_1 doi: 10.5034/inquiryjrnl_45.01.58 – ident: e_1_2_7_12_1 doi: 10.1162/rest.90.4.754 – ident: e_1_2_7_24_1 doi: 10.1111/j.1475-6773.2005.0s363.x – ident: e_1_2_7_13_1 doi: 10.1111/j.1475-6773.2012.01425.x – volume-title: Rising Demand for Long‐Term Services and Supports for Elderly People year: 2013 ident: e_1_2_7_14_1 – volume: 56 start-page: e26 issue: 5 year: 2017 ident: e_1_2_7_27_1 article-title: Constructing a Measure of Private‐Pay Nursing Home Days publication-title: Medical Care doi: 10.1097/MLR.0000000000000749 – start-page: 1 issue: 37 year: 2013 ident: e_1_2_7_15_1 article-title: Long‐Term Care Services in the United States: 2013 Overview publication-title: Vital & Health Statistics Series 3, Analytical and Epidemiological Studies – ident: e_1_2_7_18_1 doi: 10.1111/j.1475-6773.2010.01194.x – ident: e_1_2_7_25_1 doi: 10.1377/hlthaff.2009.0527 – volume-title: Medicaid Spend Down: New Estimates and Implications for Long‐Term Services and Supports Financing Reform year: 2013 ident: e_1_2_7_29_1 – ident: e_1_2_7_7_1 doi: 10.1097/MLR.0000000000000375 – ident: e_1_2_7_10_1 doi: 10.1016/S0167-6296(02)00093-0 – ident: e_1_2_7_8_1 doi: 10.1016/j.jhealeco.2011.04.001 – volume: 38 start-page: 1 year: 2016 ident: e_1_2_7_16_1 article-title: Long‐Term Care Providers and Services Users in the United States: Data from the National Study of Long‐Term Care Providers, 2013–2014 publication-title: Vital & Health Statistics Series 3, Analytical and Epidemiological Studies – ident: e_1_2_7_21_1 doi: 10.1111/j.1475-6773.2004.00240.x – volume: 78 start-page: 1 year: 2011 ident: e_1_2_7_22_1 article-title: Residential Care Facilities: A Key Sector in the Spectrum of Long‐Term Care Providers in the United States publication-title: NCHS Data Brief – ident: e_1_2_7_26_1 doi: 10.1093/geront/gns082 – ident: e_1_2_7_5_1 doi: 10.1017/S174413311300025X – volume-title: Residential Care Communities and Their Residents in 2010: A National Portrait. DHHS Publication No. 2016–1041 year: 2016 ident: e_1_2_7_20_1 – volume-title: Assisted Living Quality Initiative: Building a Structure that Promotes Quality year: 1998 ident: e_1_2_7_3_1 – ident: e_1_2_7_19_1 doi: 10.1377/hlthaff.2009.0535 – ident: e_1_2_7_23_1 doi: 10.2307/146270 – ident: e_1_2_7_6_1 – ident: e_1_2_7_11_1 doi: 10.1377/hlthaff.23.5.243 – ident: e_1_2_7_28_1 doi: 10.1097/MLR.0000000000000659 – volume-title: DataExplorer – Assisted Living and Residential Care Facilities year: 2017 ident: e_1_2_7_2_1
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Snippet	Objective Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for... Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long-term... Principal Findings. Mean AL beds per county increased from 285 to 324, while NHs exhibited a decrease in private-pay residents (20.1 to 17.7 percent) and... Objective. Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for... ObjectiveGiven the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for... Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long-term...
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SubjectTerms	Aged Aged, 80 and over Analysis Assisted living Assisted living facilities Assisted Living Facilities - statistics & numerical data Censuses Counties Enrollments Health Expenditures - statistics & numerical data Health services Humans Insurance Claim Review Length of residency Long term care Long term health care Long-term care of the sick Markets Medicaid - economics Medicare Medicare - economics Medicare - statistics & numerical data nursing home Nursing homes Nursing Homes - statistics & numerical data Prevalence Residents Retrospective Studies Services Skilled Nursing Care, Quality, and Cost Studies United States
Title	Increasing Prevalence of Assisted Living as a Substitute for Private‐Pay Long‐Term Nursing Care
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