Value-Based Care Drives Growth and Stability in Skilled Nursing Facilities

Skilled nursing facilities (SNFs) are increasingly participating in value-based care (VBC) models, which focus on patient outcomes and coordinated care rather than volume of services provided. This shift is driven by Centers for Medicare & Medicaid Services (CMS) policies such as the Patient Driven Payment Model (PDPM) that emphasize quality and patient need. Skilled nursing operators are either already involved in these models or will soon be affected, making it critical for them to understand how to leverage VBC to improve care, operational efficiency, and financial performance. Curana Health, a company specializing in skilled nursing and senior living, supports operators by providing on-site care services like medical directorship, post-acute care, behavioral and primary care, as well as assistance in participating in VBC programs including Accountable Care Organizations (ACOs) and Medicare Advantage Special Needs Plans (MA SNPs). These programs offer opportunities for shared savings and risk-adjusted capitation payments, providing financial incentives for improved care coordination. Long-term care operations face challenges due to lower Medicaid reimbursement rates, making VBC participation an avenue to better cover the cost of care. Operators sponsoring or partnering with MA SNPs can use monthly capitation payments to enhance resident benefits, expand wellness programs, and bolster staff support. ACO participation can provide shared savings and include benefits like the three-day hospital stay waiver, allowing residents to receive rehab care within their current facility, thereby reducing hospital transfers and associated complications. Value-based care models also benefit short-stay patients. Enhanced medical directorship and accurate documentation protocols improve risk profiling and health status detection, reducing preventable hospitalizations. This also supports coding accuracy for reimbursement purposes. Physician leadership under VBC models promotes quality assurance, medication management, and survey compliance, contributing to improved quality ratings and stronger referral networks. Skilled nursing operators are encouraged to recognize the value they provide and to consider incremental adoption of VBC models that align with their risk tolerance and organizational goals. Starting with either ACOs or MA SNPs can lay the foundation for broader value-based initiatives, streamlining future implementations and operational integration. The year 2026 is projected as a pivotal point where value-based care becomes standard practice in post-acute and long-term care settings. Operators will increasingly join ACOs, launch or partner on MA SNPs, and build clinical infrastructure to support these models. Proactive engagement in VBC is essential to capitalize on opportunities for improved resident health outcomes and greater operational stability. Ultimately, skilled nursing providers play a crucial role in the success of value-based care systems, and aligning care delivery with VBC frameworks offers pathways to sustainability amidst evolving healthcare regulations. The transition reflects a broader healthcare move toward accountability and coordinated care benefiting residents, caregivers, and providers alike.