Effects of Nursing Home Participation in the Medicare Shared Savings Program on Staffing and Deficiency Citations

The Medicare Shared Savings Program (MSSP) is the largest value-based payment model in the United States, yet its impacts on participating nursing homes remain poorly understood. This study investigates the effects of nursing home participation in the MSSP on nursing home staffing patterns and deficiency citations. Using comprehensive data on all U.S. nursing homes from 2013 to 2018 and employing difference-in-differences models, we find evidence that MSSP participation is associated with increased registered nurse (RN) staffing, reduced licensed practical nurse (LPN) staffing, and a decline in deficiency citations. As nursing home participation in the MSSP continues to grow, more evidence is needed to understand the program's broader implications for facility operations, care quality, and patient health outcomes.