Disparities in Post-Acute Care Access among Older Adults with Substance Use Disorder

After a hospital discharge, skilled nursing facilities (SNF) are common post-acute care destinations for older adults with substance use disorder (SUD). Skilled nursing facilities offer short-term or inpatient rehabilitation services and a structured environment for patients to initiate or continue treatment for SUD. A growing body of evidence, however, captures barriers to SNF placement for this population, such as high rejections rates for post-acute care referral and discriminatory practices related to opioid use disorder (OUD) and/or medications for OUD.

Led by Courtney Baird, this pilot study will be the first to generate national evidence on disparities in access to SNF care among older adults with SUD who are Medicare beneficiaries. Using national data from Medicare claims, the Five-Star Quality Rating System by the Centers for Medicare & Medicaid Services, and Long-term Care: Facts on Care in the U.S., Baird will compare discharge patterns and SNF characteristics for patients with and without SUD. Findings aim to improve SNF access for the growing aging population with SUD.

Courtney Baird is a postdoctoral associate in the Division of Health Policy and Economics in the Department of Population Health Sciences at Weill Cornell Medicine. Her research leverages large datasets, including Medicare claims data, to understand the impacts of healthcare policies and practices on care quality and health outcomes for older adults. Her dissertation research, supported by an R36 grant from the Agency for Healthcare Research and Quality, focused on evaluating the impact of the Medicare Shared Savings Program on fall prevention services and fall-related injuries among community-dwelling older adults in the Fee-for-Service Medicare population. She received her PhD in health services research from Brown University and earned her master’s degree in health policy and economics from Weill Cornell Graduate School of Medical Sciences.