Market and regulatory forces and the transformation of the nursing facility industry

Abstract

This chapter employs a case study research design to investigate why and how nursing facilities are entering into relationships with hospital systems and managed care. Resource dependence theory provides the conceptual framework for analysis of data from a seven-market case study. These data indicate that nursing facility relationships with systems and managed care vary depending on local circumstances. However, nursing facilities nationwide are providing more specialized care of higher acuity in response to market opportunities. In the context of the current market environment, the implementation of case mix reimbursement under Medicare's Prospective Payment System for skilled nursing facilities may have unanticipated consequences, including a reduction in the number of Medicare-certified facilities, a reduction in the number of hospital-based facilities, and changes in facility staff composition. Both policy and managerial implications are considered.

Citation

Zinn, J.S., Mor, V. and Gozalo, P. (2000), "Market and regulatory forces and the transformation of the nursing facility industry", Advances in Health Care Management (Advances in Health Care Management, Vol. 1), Emerald Group Publishing Limited, Leeds, pp. 369-391. https://doi.org/10.1016/S1474-8231(00)01014-4