The research provided evidence that acuity-adjusted Medicaid staffing incentives can drive measurable gains in nurse staffing levels and resident health outcomes.
Health Impacts of Nursing Home Staffing
“In this case-control study, we found that a Medicaid policy that incentivized high staffing levels was associated with modest improvement in some dimensions of patient health. However, even modest effects are extremely meaningful at scale: these estimates suggest that if a similar reform were adopted nationally, there would be 6142 fewer hospitalizations each year.”
Olenski, Andrew, et al. “Health Impacts of Nursing Home Staffing.” JAMA Health Forum, 16 Jan. 2026. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2843824
“A Medicaid policy that incentivized greater staffing, with bonus reimbursements up to $38.68 per resident day and based on acuity-adjusted staffing levels, resulted in a 12.2% increase in nurse staffing compared to the baseline level. There’s evidence to suggest the Illinois reform impacted patient health, with 90-day hospitalization rates decreasing by 0.51 percentage points compared to other states.”
— Skilled Nursing News, January 16, 2026
Nationalizing this nursing home staffing incentive could cut annual hospitalizations by 6,000
“Our research suggests that tying payments to staffing does cause facilities to target increases in staffing, and that targeted increases in staffing appear to have measurable health benefits.” — Ashvin Gandhi, assistant professor of economics, UCLA
— McKnight’s Long-Term Care News, January 16, 2026
