Medicaid Lesser-of Rules and Disparities in Skilled Nursing Facility Quality

This cross-sectional study found that disparities in access to higher-quality SNFs between dually eligible and Medicare-only beneficiaries were larger when states used lesser-of rules for determining Medicare coinsurance reimbursements. Our findings underscore the need for policies that address states’ Medicare spending without shifting costs to health care organizations serving the vulnerable dually eligible population.

Corresponding Author: Cyrus M. Kosar, PhD, Brown University School of Public Health, 121 S Main St, Providence, RI 02912 (cyrus_kosar@brown.edu).

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