Disparities in Access to Highly Rated Skilled Nursing Facilities among Medicare Beneficiaries with Opioid Use Disorder.

The study only captured patients who successfully entered an SNF. It lacked data on referral rejections, which are known to be higher for patients with OUD, meaning the results likely underestimate the true disparity in access. OUD status was determined from hospital claims data, so patients whose OUD was not documented or was not a primary reason for admission were excluded. The findings apply only to fee-for-service Medicare beneficiaries and may not generalize to those in Medicare Advantage plans. The differences in star ratings were small in magnitude, and the authors note that the clinical significance of these disparities is difficult to ascertain.

The authors declared no conflicts of interest. The study was supported by the National Institutes of Health.

Do not interpret the small difference in mean star ratings (3.40 vs 3.46) as evidence that patients with OUD receive significantly worse clinical care within these facilities. The study measures access to highly-rated buildings, not patient outcomes or care quality delivered, and the authors explicitly state the clinical significance is difficult to ascertain.