{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T17:42:34Z","timestamp":1792258954697,"version":"4.4.0"},"reference-count":56,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["AG065371"],"award-info":[{"award-number":["AG065371"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TL1TR002318"],"award-info":[{"award-number":["TL1TR002318"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Appl Gerontol"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cancer patients experience suboptimal care in skilled nursing facilities (SNFs). Medicare\u2019s Patient-Driven Payment Model (PDPM) incentivized SNFs to admit complex patients, potentially promoting admissions without appropriate changes in care delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate changes in SNF admissions, rehabilitation therapy volume, and chemotherapy\/radiation around admission or discharge, following PDPM and COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adjusted interrupted time series examining 1,125,782 hospital stays from metastatic cancer patients, using 100% Traditional Medicare claims (2018\u20132021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PDPM was associated with increased SNF admissions (0.47 pp\/month; 95% CI: [0.17, 0.76]) and an immediate reduction in therapy volume (\u221224.95 minutes per day, 95% CI: [\u221226.40, \u221223.48]). Chemotherapy use remained low, but increased by 21% at PDPM implementation, without subsequent slope change (RR: 1.21; 95% CI: [1.01, 1.46]); radiation was unchanged. COVID-19 reversed admission gains. SNF admissions for metastatic cancer patients increased without sustained changes in cancer-relevant care delivery, warranting investigation of health outcomes and outcome-driven policy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07334648261494384","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:43:10Z","timestamp":1792021390000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Incentives for Access: Changes in Admissions and Care Delivery for Metastatic Cancer Patients in Medicare Skilled Nursing Facilities, After the Patient-Driven Payment Model"],"prefix":"10.1177","author":[{"given":"Harsha","family":"Amaravadi","sequence":"first","affiliation":[{"name":"University of Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel A.","family":"Prusynski","sequence":"additional","affiliation":[{"name":"University of Washington"},{"name":"University of Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Fishman","sequence":"additional","affiliation":[{"name":"University of Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda I.","family":"Phipps","sequence":"additional","affiliation":[{"name":"University of Washington"},{"name":"Fred Hutchinson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie E.","family":"Leland","sequence":"additional","affiliation":[{"name":"University of Pittsburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy M.","family":"Mroz","sequence":"additional","affiliation":[{"name":"University of Washington"},{"name":"University of Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.70084"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.0853001"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2025.105853"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2009.1090"},{"key":"e_1_3_5_6_1","volume-title":"Program memorandum intermediaries, transmittal A-00-01: Consolidated billing for skilled nursing facility (SNF) patients when receiving outpatient\/emergency care in a medicare-participating hospital or critical access hospital (CAH)","author":"Centers for Medicare & Medicaid Services","year":"2000","unstructured":"Centers for Medicare & Medicaid Services. 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