SNF ACO tables and figures

Generated 2026-10-28 08:29. Cost report rules: 360-370 day reports; FY-to-CY attribution OFF; gov't/territory exclusion ON; other income NA-to-zero ON; G-3 winsorized by year ON.

Tables

Figures

Tables

Table A1. Days in cost reporting period, before the 360-370 day filter
statistic days
min 28
p1 61
p5 182
p25 364
median 364
p75 364
p95 365
p99 365
max 457
n missing 0
n reports 58,374
Days = FY end date minus FY begin date (Stata arithmetic).
Table A2. Government-owned and territory facilities, by ACO affiliation
ever_aco n_ccns excluded
Never ACO-affiliated 693 TRUE
Ever ACO-affiliated 18 TRUE
Total 711 -
For the Tyler discussion of whether to keep this exclusion.
Table A3. Distribution of total other income by year and ever-ACO status
YEAR ever_aco n_reports n_missing pct_missing n_missing_but_npsr_ok n_zero n_negative p01 p10 p25 p50 p75 p90 p99
2,021 Ever ACO 754 12 1.600 12 0 11 −2,237 154,200 466,100 1,032,000 2,074,000 5,130,000 16,030,000
2,021 Never ACO 11,799 141 1.200 138 0 170 −43,910 33,720 235,700 611,400 1,305,000 2,776,000 20,070,000
2,022 Ever ACO 754 16 2.100 16 0 33 −1,695,000 16,820 112,500 398,900 1,050,000 3,169,000 20,750,000
2,022 Never ACO 11,611 125 1.100 119 0 322 −315,400 6,929 73,140 300,100 755,900 1,723,000 17,910,000
2,023 Ever ACO 738 14 1.900 13 0 20 −14,160 5,305 75,670 372,800 1,121,000 3,526,000 24,990,000
2,023 Never ACO 11,387 178 1.600 171 0 322 −37,530 2,580 22,800 182,200 599,000 1,638,000 23,690,000
2,024 Ever ACO 749 16 2.100 16 0 34 −74,880 1,765 21,070 194,100 817,300 3,425,000 27,670,000
2,024 Never ACO 11,399 304 2.700 294 0 584 −80,590 639.6 7,952 59,420 339,100 1,186,000 26,440,000
Before the NA-to-zero fill. 'Missing but NPSR ok' = candidates for a true zero.
Table A4. G-3 winsorization cutoffs (1st/99th percentile) by year
YEAR total_patient_revenue_gross_p01 total_patient_revenue_gross_p99 net_patient_service_revenue_p01 net_patient_service_revenue_p99 total_operating_expenses_p01 total_operating_expenses_p99 net_income_from_patient_services_p01 net_income_from_patient_services_p99 total_other_income_p01 total_other_income_p99
2,021 2,085,000 48,610,000 1,951,000 39,440,000 2,339,000 44,960,000 −17,640,000 3,668,000 −37,590 19,670,000
2,022 2,253,000 50,750,000 2,080,000 42,960,000 2,526,000 48,840,000 −19,400,000 3,672,000 −397,800 17,920,000
2,023 2,557,000 55,650,000 2,360,000 44,580,000 2,714,000 52,390,000 −23,030,000 3,828,000 −36,030 23,700,000
2,024 2,768,000 59,100,000 2,632,000 47,560,000 2,893,000 55,720,000 −22,940,000 4,453,000 −76,040 26,290,000
Applied to raw dollar fields before per-day ratios.
Table A5. ACO-affiliated SNFs by year
year n_snfs n_entries n_exits net_change pct_change
2,021 267 – – – –
2,022 350 117 34 83 31.10
2,023 365 82 67 15 4.300
2,024 434 152 83 69 18.90
2,025 513 148 69 79 18.20
2,026 525 122 110 12 2.300
Table A6. Facilities by ACO participation pattern
pattern n_facilities pct
Never participated 13,876 94.40
Single entry, no exit 349 2.400
Entered and exited, no return 286 1.900
Continuously affiliated 125 0.9000
Cycled (exited and reentered) 63 0.4000
Table A7. Kruskal-Wallis omnibus tests by ACO category
outcome group_var n_obs statistic df p_value eps_sq magnitude p_adj_bh domain
qm_pressure_ulcers_ls treatment_group 12,808 13.11 2 0.001420 0.0008677 small 0.001671 Quality (MDS rates)
qm_falls_major_inj_ls treatment_group 12,811 0.9607 2 0.6190 −0.00008115 small 0.6190 Quality (MDS rates)
qm_uti_ls treatment_group 12,808 9.787 2 0.007490 0.0006081 small 0.008322 Quality (MDS rates)
qm_antipsychotic_ls treatment_group 12,581 21.58 2 0.00002060 0.001556 small 0.00003169 Quality (MDS rates)
qm_antipsychotic_new_ss treatment_group 12,463 15.63 2 0.0004040 0.001094 small 0.0005387 Quality (MDS rates)
overall_rating treatment_group 12,960 266.8 2 0.0000000000000000000000000000000000000000000000000000000001160 0.02044 small 0.000000000000000000000000000000000000000000000000000000002320 Star ratings
health_inspection_rating treatment_group 12,960 207.7 2 0.0000000000000000000000000000000000000000000007870 0.01588 small 0.000000000000000000000000000000000000000000007870 Star ratings
staffing_rating treatment_group 12,914 152.5 2 0.0000000000000000000000000000000007510 0.01166 small 0.000000000000000000000000000000005007 Star ratings
qm_rating treatment_group 12,909 64.26 2 0.00000000000001110 0.004824 small 0.00000000000001850 Star ratings
long_stay_qm_rating treatment_group 12,662 21.03 2 0.00002710 0.001503 small 0.00003871 Star ratings
short_stay_qm_rating treatment_group 11,032 85.28 2 0.0000000000000000003030 0.007551 small 0.0000000000000000007575 Star ratings
reported_rn_staffing_hours_per_resident_per_day treatment_group 12,624 117.9 2 0.00000000000000000000000002510 0.009183 small 0.0000000000000000000000001004 Staffing hours
reported_lpn_staffing_hours_per_resident_per_day treatment_group 12,624 3.037 2 0.2190 0.00008217 small 0.2305 Staffing hours
reported_nurse_aide_staffing_hours_per_resident_per_day treatment_group 12,624 80.72 2 0.000000000000000002960 0.006237 small 0.000000000000000005920 Staffing hours
reported_licensed_staffing_hours_per_resident_per_day treatment_group 12,624 104.7 2 0.00000000000000000000001840 0.008137 small 0.00000000000000000000006133 Staffing hours
total_patient_revenue_gross treatment_group 12,826 76.98 2 0.00000000000000001920 0.005848 small 0.00000000000000003491 Financial
net_patient_service_revenue treatment_group 12,826 83.98 2 0.0000000000000000005820 0.006393 small 0.000000000000000001293 Financial
total_other_income treatment_group 12,826 125.7 2 0.0000000000000000000000000005150 0.009644 small 0.000000000000000000000000002575 Financial
net_income_from_patient_services treatment_group 12,830 14.77 2 0.0006200 0.0009957 small 0.0007750 Financial
total_operating_expenses treatment_group 12,829 93.36 2 0.000000000000000000005340 0.007123 small 0.00000000000000000001526 Financial
qm_pressure_ulcers_ls aco_adopter_type 12,808 12.55 3 0.005710 0.0007461 small 0.006718 Quality (MDS rates)
qm_falls_major_inj_ls aco_adopter_type 12,811 7.361 3 0.06120 0.0003405 small 0.06442 Quality (MDS rates)
qm_uti_ls aco_adopter_type 12,808 10.90 3 0.01230 0.0006172 small 0.01367 Quality (MDS rates)
qm_antipsychotic_ls aco_adopter_type 12,581 23.64 3 0.00002970 0.001641 small 0.00004569 Quality (MDS rates)
qm_antipsychotic_new_ss aco_adopter_type 12,463 14.01 3 0.002890 0.0008837 small 0.003613 Quality (MDS rates)
overall_rating aco_adopter_type 12,960 160.2 3 0.0000000000000000000000000000000001620 0.01214 small 0.000000000000000000000000000000003240 Star ratings
health_inspection_rating aco_adopter_type 12,960 112.7 3 0.000000000000000000000002870 0.008468 small 0.00000000000000000000001435 Star ratings
staffing_rating aco_adopter_type 12,914 136.2 3 0.00000000000000000000000000002550 0.01031 small 0.0000000000000000000000000002550 Star ratings
qm_rating aco_adopter_type 12,909 56.49 3 0.000000000003310 0.004145 small 0.000000000005517 Star ratings
long_stay_qm_rating aco_adopter_type 12,662 20.73 3 0.0001200 0.001401 small 0.0001600 Star ratings
short_stay_qm_rating aco_adopter_type 11,032 75.10 3 0.0000000000000003440 0.006538 small 0.0000000000000006880 Star ratings
reported_rn_staffing_hours_per_resident_per_day aco_adopter_type 12,624 102.0 3 0.0000000000000000000005850 0.007843 small 0.000000000000000000001950 Staffing hours
reported_lpn_staffing_hours_per_resident_per_day aco_adopter_type 12,624 1.562 3 0.6680 −0.0001139 small 0.6680 Staffing hours
reported_nurse_aide_staffing_hours_per_resident_per_day aco_adopter_type 12,624 71.87 3 0.000000000000001690 0.005458 small 0.000000000000003073 Staffing hours
reported_licensed_staffing_hours_per_resident_per_day aco_adopter_type 12,624 86.34 3 0.000000000000000001340 0.006604 small 0.000000000000000002978 Staffing hours
total_patient_revenue_gross aco_adopter_type 12,826 89.17 3 0.0000000000000000003310 0.006720 small 0.0000000000000000008275 Financial
net_patient_service_revenue aco_adopter_type 12,826 95.44 3 0.00000000000000000001480 0.007210 small 0.00000000000000000004229 Financial
total_other_income aco_adopter_type 12,826 129.5 3 0.0000000000000000000000000007000 0.009864 small 0.000000000000000000000000004667 Financial
net_income_from_patient_services aco_adopter_type 12,830 22.54 3 0.00005030 0.001524 small 0.00007186 Financial
total_operating_expenses aco_adopter_type 12,829 109.8 3 0.00000000000000000000001230 0.008325 small 0.00000000000000000000004920 Financial
Table A8. Pairwise Dunn tests by ACO category
outcome group_var group1 group2 n1 n2 statistic p p_adj p_adj_signif
qm_pressure_ulcers_ls treatment_group Never participated Exited before 2026 12,057 278 −0.8835 0.3769 0.3769 ns
qm_pressure_ulcers_ls treatment_group Never participated Participating as of 2026 12,057 473 −3.536 0.0004067 0.001220 **
qm_pressure_ulcers_ls treatment_group Exited before 2026 Participating as of 2026 278 473 −1.484 0.1379 0.2068 ns
qm_falls_major_inj_ls treatment_group Never participated Exited before 2026 12,060 278 0.3547 0.7228 0.7732 ns
qm_falls_major_inj_ls treatment_group Never participated Participating as of 2026 12,060 473 0.9237 0.3557 0.7732 ns
qm_falls_major_inj_ls treatment_group Exited before 2026 Participating as of 2026 278 473 0.2882 0.7732 0.7732 ns
qm_uti_ls treatment_group Never participated Exited before 2026 12,057 278 1.771 0.07662 0.1149 ns
qm_uti_ls treatment_group Never participated Participating as of 2026 12,057 473 2.630 0.008545 0.02564 *
qm_uti_ls treatment_group Exited before 2026 Participating as of 2026 278 473 0.2098 0.8339 0.8339 ns
qm_antipsychotic_ls treatment_group Never participated Exited before 2026 11,846 270 −2.693 0.007078 0.01062 *
qm_antipsychotic_ls treatment_group Never participated Participating as of 2026 11,846 465 −3.861 0.0001129 0.0003386 ***
qm_antipsychotic_ls treatment_group Exited before 2026 Participating as of 2026 270 465 −0.2193 0.8264 0.8264 ns
qm_antipsychotic_new_ss treatment_group Never participated Exited before 2026 11,697 278 −1.004 0.3156 0.3156 ns
qm_antipsychotic_new_ss treatment_group Never participated Participating as of 2026 11,697 488 −3.853 0.0001167 0.0003502 ***
qm_antipsychotic_new_ss treatment_group Exited before 2026 Participating as of 2026 278 488 −1.558 0.1191 0.1787 ns
overall_rating treatment_group Never participated Exited before 2026 12,184 285 −0.6487 0.5165 0.5165 ns
overall_rating treatment_group Never participated Participating as of 2026 12,184 491 16.29 0.00000000000000000000000000000000000000000000000000000000001073 0.00000000000000000000000000000000000000000000000000000000003220 ****
overall_rating treatment_group Exited before 2026 Participating as of 2026 285 491 10.59 0.00000000000000000000000003173 0.00000000000000000000000004759 ****
health_inspection_rating treatment_group Never participated Exited before 2026 12,184 285 −1.680 0.09290 0.09290 ns
health_inspection_rating treatment_group Never participated Participating as of 2026 12,184 491 14.26 0.0000000000000000000000000000000000000000000004023 0.000000000000000000000000000000000000000000001207 ****
health_inspection_rating treatment_group Exited before 2026 Participating as of 2026 285 491 10.16 0.000000000000000000000002842 0.000000000000000000000004263 ****
staffing_rating treatment_group Never participated Exited before 2026 12,143 284 3.072 0.002124 0.002124 **
staffing_rating treatment_group Never participated Participating as of 2026 12,143 487 12.05 0.000000000000000000000000000000001974 0.000000000000000000000000000000005921 ****
staffing_rating treatment_group Exited before 2026 Participating as of 2026 284 487 4.988 0.0000006114 0.0000009172 ****
qm_rating treatment_group Never participated Exited before 2026 12,136 284 2.282 0.02250 0.02250 *
qm_rating treatment_group Never participated Participating as of 2026 12,136 489 7.749 0.000000000000009272 0.00000000000002782 ****
qm_rating treatment_group Exited before 2026 Participating as of 2026 284 489 2.955 0.003131 0.004697 **
long_stay_qm_rating treatment_group Never participated Exited before 2026 11,918 276 1.791 0.07325 0.1099 ns
long_stay_qm_rating treatment_group Never participated Participating as of 2026 11,918 468 4.272 0.00001935 0.00005805 ****
long_stay_qm_rating treatment_group Exited before 2026 Participating as of 2026 276 468 1.216 0.2241 0.2241 ns
short_stay_qm_rating treatment_group Never participated Exited before 2026 10,303 262 2.344 0.01906 0.01906 *
short_stay_qm_rating treatment_group Never participated Participating as of 2026 10,303 467 9.004 0.0000000000000000002171 0.0000000000000000006514 ****
short_stay_qm_rating treatment_group Exited before 2026 Participating as of 2026 262 467 3.619 0.0002959 0.0004439 ***
reported_rn_staffing_hours_per_resident_per_day treatment_group Never participated Exited before 2026 11,877 273 2.833 0.004618 0.004618 **
reported_rn_staffing_hours_per_resident_per_day treatment_group Never participated Participating as of 2026 11,877 474 10.56 0.00000000000000000000000004538 0.0000000000000000000000001361 ****
reported_rn_staffing_hours_per_resident_per_day treatment_group Exited before 2026 Participating as of 2026 273 474 4.228 0.00002355 0.00003532 ****
reported_lpn_staffing_hours_per_resident_per_day treatment_group Never participated Exited before 2026 11,877 273 −0.3901 0.6965 0.6965 ns
reported_lpn_staffing_hours_per_resident_per_day treatment_group Never participated Participating as of 2026 11,877 474 1.686 0.09174 0.2637 ns
reported_lpn_staffing_hours_per_resident_per_day treatment_group Exited before 2026 Participating as of 2026 273 474 1.354 0.1758 0.2637 ns
reported_nurse_aide_staffing_hours_per_resident_per_day treatment_group Never participated Exited before 2026 11,877 273 2.086 0.03698 0.03698 *
reported_nurse_aide_staffing_hours_per_resident_per_day treatment_group Never participated Participating as of 2026 11,877 474 8.796 0.000000000000000001413 0.000000000000000004239 ****
reported_nurse_aide_staffing_hours_per_resident_per_day treatment_group Exited before 2026 Participating as of 2026 273 474 3.742 0.0001825 0.0002737 ***
reported_licensed_staffing_hours_per_resident_per_day treatment_group Never participated Exited before 2026 11,877 273 2.115 0.03441 0.03441 *
reported_licensed_staffing_hours_per_resident_per_day treatment_group Never participated Participating as of 2026 11,877 474 10.07 0.000000000000000000000007580 0.00000000000000000000002274 ****
reported_licensed_staffing_hours_per_resident_per_day treatment_group Exited before 2026 Participating as of 2026 273 474 4.503 0.000006697 0.00001005 ****
total_patient_revenue_gross treatment_group Never participated Exited before 2026 12,064 277 4.809 0.000001519 0.000002279 ****
total_patient_revenue_gross treatment_group Never participated Participating as of 2026 12,064 485 7.477 0.00000000000007585 0.0000000000002275 ****
total_patient_revenue_gross treatment_group Exited before 2026 Participating as of 2026 277 485 0.7178 0.4729 0.4729 ns
net_patient_service_revenue treatment_group Never participated Exited before 2026 12,064 277 4.743 0.000002107 0.000003160 ****
net_patient_service_revenue treatment_group Never participated Participating as of 2026 12,064 485 7.977 0.000000000000001496 0.000000000000004487 ****
net_patient_service_revenue treatment_group Exited before 2026 Participating as of 2026 277 485 1.078 0.2809 0.2809 ns
total_other_income treatment_group Never participated Exited before 2026 12,064 277 5.259 0.0000001447 0.0000002170 ****
total_other_income treatment_group Never participated Participating as of 2026 12,064 485 10.05 0.000000000000000000000009140 0.00000000000000000000002742 ****
total_other_income treatment_group Exited before 2026 Participating as of 2026 277 485 1.937 0.05279 0.05279 ns
net_income_from_patient_services treatment_group Never participated Exited before 2026 12,068 277 −2.217 0.02663 0.03994 *
net_income_from_patient_services treatment_group Never participated Participating as of 2026 12,068 485 −3.203 0.001358 0.004074 **
net_income_from_patient_services treatment_group Exited before 2026 Participating as of 2026 277 485 −0.1810 0.8564 0.8564 ns
total_operating_expenses treatment_group Never participated Exited before 2026 12,067 277 5.000 0.0000005738 0.0000008607 ****
total_operating_expenses treatment_group Never participated Participating as of 2026 12,067 485 8.412 0.00000000000000004042 0.0000000000000001212 ****
total_operating_expenses treatment_group Exited before 2026 Participating as of 2026 277 485 1.138 0.2551 0.2551 ns
qm_pressure_ulcers_ls aco_adopter_type Never participated Early adopter (2021-2022) 12,057 354 −2.687 0.007215 0.04329 *
qm_pressure_ulcers_ls aco_adopter_type Never participated Mid adopter (2023-2024) 12,057 197 −0.6525 0.5141 0.6169 ns
qm_pressure_ulcers_ls aco_adopter_type Never participated Late adopter (2025-2026) 12,057 200 −2.298 0.02155 0.06465 ns
qm_pressure_ulcers_ls aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 354 197 1.103 0.2702 0.4053 ns
qm_pressure_ulcers_ls aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 354 200 −0.2144 0.8302 0.8302 ns
qm_pressure_ulcers_ls aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 197 200 −1.165 0.2439 0.4053 ns
qm_falls_major_inj_ls aco_adopter_type Never participated Early adopter (2021-2022) 12,060 354 1.720 0.08535 0.1428 ns
qm_falls_major_inj_ls aco_adopter_type Never participated Mid adopter (2023-2024) 12,060 197 1.230 0.2185 0.2622 ns
qm_falls_major_inj_ls aco_adopter_type Never participated Late adopter (2025-2026) 12,060 200 −1.669 0.09520 0.1428 ns
qm_falls_major_inj_ls aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 354 197 −0.04943 0.9606 0.9606 ns
qm_falls_major_inj_ls aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 354 200 −2.394 0.01668 0.1001 ns
qm_falls_major_inj_ls aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 197 200 −2.066 0.03887 0.1166 ns
qm_uti_ls aco_adopter_type Never participated Early adopter (2021-2022) 12,057 354 1.985 0.04713 0.1414 ns
qm_uti_ls aco_adopter_type Never participated Mid adopter (2023-2024) 12,057 197 2.497 0.01252 0.07511 ns
qm_uti_ls aco_adopter_type Never participated Late adopter (2025-2026) 12,057 200 1.047 0.2949 0.4455 ns
qm_uti_ls aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 354 197 0.8136 0.4159 0.4991 ns
qm_uti_ls aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 354 200 −0.3659 0.7144 0.7144 ns
qm_uti_ls aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 197 200 −1.043 0.2970 0.4455 ns
qm_antipsychotic_ls aco_adopter_type Never participated Early adopter (2021-2022) 11,846 347 −3.784 0.0001542 0.0009249 ***
qm_antipsychotic_ls aco_adopter_type Never participated Mid adopter (2023-2024) 11,846 190 −2.924 0.003450 0.01035 *
qm_antipsychotic_ls aco_adopter_type Never participated Late adopter (2025-2026) 11,846 198 −1.232 0.2179 0.2615 ns
qm_antipsychotic_ls aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 347 190 −0.08592 0.9315 0.9315 ns
qm_antipsychotic_ls aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 347 198 1.323 0.1859 0.2615 ns
qm_antipsychotic_ls aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 190 198 1.236 0.2163 0.2615 ns
qm_antipsychotic_new_ss aco_adopter_type Never participated Early adopter (2021-2022) 11,697 358 −2.264 0.02357 0.07070 ns
qm_antipsychotic_new_ss aco_adopter_type Never participated Mid adopter (2023-2024) 11,697 203 −1.510 0.1310 0.2620 ns
qm_antipsychotic_new_ss aco_adopter_type Never participated Late adopter (2025-2026) 11,697 205 −2.673 0.007513 0.04508 *
qm_antipsychotic_new_ss aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 358 203 0.1658 0.8683 0.8683 ns
qm_antipsychotic_new_ss aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 358 205 −0.7633 0.4453 0.5343 ns
qm_antipsychotic_new_ss aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 203 205 −0.8223 0.4109 0.5343 ns
overall_rating aco_adopter_type Never participated Early adopter (2021-2022) 12,184 366 8.703 0.000000000000000003219 0.00000000000000001931 ****
overall_rating aco_adopter_type Never participated Mid adopter (2023-2024) 12,184 205 4.848 0.000001249 0.000002497 ****
overall_rating aco_adopter_type Never participated Late adopter (2025-2026) 12,184 205 8.188 0.0000000000000002658 0.0000000000000007974 ****
overall_rating aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 366 205 −1.379 0.1679 0.1877 ns
overall_rating aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 366 205 1.318 0.1877 0.1877 ns
overall_rating aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 205 205 2.382 0.01724 0.02585 *
health_inspection_rating aco_adopter_type Never participated Early adopter (2021-2022) 12,184 366 6.801 0.00000000001037 0.00000000003110 ****
health_inspection_rating aco_adopter_type Never participated Mid adopter (2023-2024) 12,184 205 3.595 0.0003244 0.0006489 ***
health_inspection_rating aco_adopter_type Never participated Late adopter (2025-2026) 12,184 205 7.589 0.00000000000003215 0.0000000000001929 ****
health_inspection_rating aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 366 205 −1.234 0.2173 0.2173 ns
health_inspection_rating aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 366 205 1.991 0.04648 0.05577 ns
health_inspection_rating aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 205 205 2.848 0.004398 0.006597 **
staffing_rating aco_adopter_type Never participated Early adopter (2021-2022) 12,143 364 8.867 0.0000000000000000007531 0.000000000000000004518 ****
staffing_rating aco_adopter_type Never participated Mid adopter (2023-2024) 12,143 204 7.087 0.000000000001372 0.000000000004117 ****
staffing_rating aco_adopter_type Never participated Late adopter (2025-2026) 12,143 203 3.466 0.0005281 0.001056 **
staffing_rating aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 364 204 0.3278 0.7431 0.7431 ns
staffing_rating aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 364 203 −2.584 0.009763 0.01212 *
staffing_rating aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 204 203 −2.573 0.01010 0.01212 *
qm_rating aco_adopter_type Never participated Early adopter (2021-2022) 12,136 366 5.864 0.000000004509 0.00000002706 ****
qm_rating aco_adopter_type Never participated Mid adopter (2023-2024) 12,136 204 3.229 0.001243 0.002485 **
qm_rating aco_adopter_type Never participated Late adopter (2025-2026) 12,136 203 3.710 0.0002074 0.0006221 ***
qm_rating aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 366 204 −0.9518 0.3412 0.5118 ns
qm_rating aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 366 203 −0.5550 0.5789 0.6947 ns
qm_rating aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 204 203 0.3489 0.7272 0.7272 ns
long_stay_qm_rating aco_adopter_type Never participated Early adopter (2021-2022) 11,918 353 3.845 0.0001204 0.0007224 ***
long_stay_qm_rating aco_adopter_type Never participated Mid adopter (2023-2024) 11,918 194 1.618 0.1057 0.2113 ns
long_stay_qm_rating aco_adopter_type Never participated Late adopter (2025-2026) 11,918 197 1.999 0.04556 0.1367 ns
long_stay_qm_rating aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 353 194 −1.013 0.3109 0.4663 ns
long_stay_qm_rating aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 353 197 −0.7202 0.4714 0.5657 ns
long_stay_qm_rating aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 194 197 0.2622 0.7932 0.7932 ns
short_stay_qm_rating aco_adopter_type Never participated Early adopter (2021-2022) 10,303 340 6.993 0.000000000002682 0.00000000001609 ****
short_stay_qm_rating aco_adopter_type Never participated Mid adopter (2023-2024) 10,303 193 3.201 0.001371 0.002743 **
short_stay_qm_rating aco_adopter_type Never participated Late adopter (2025-2026) 10,303 196 4.347 0.00001382 0.00004146 ****
short_stay_qm_rating aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 340 193 −1.697 0.08968 0.1345 ns
short_stay_qm_rating aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 340 196 −0.8035 0.4217 0.4251 ns
short_stay_qm_rating aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 193 196 0.7976 0.4251 0.4251 ns
reported_rn_staffing_hours_per_resident_per_day aco_adopter_type Never participated Early adopter (2021-2022) 11,877 354 7.639 0.00000000000002181 0.0000000000001309 ****
reported_rn_staffing_hours_per_resident_per_day aco_adopter_type Never participated Mid adopter (2023-2024) 11,877 193 5.523 0.00000003323 0.00000009970 ****
reported_rn_staffing_hours_per_resident_per_day aco_adopter_type Never participated Late adopter (2025-2026) 11,877 200 4.108 0.00003992 0.00007985 ****
reported_rn_staffing_hours_per_resident_per_day aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 354 193 −0.1255 0.9001 0.9001 ns
reported_rn_staffing_hours_per_resident_per_day aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 354 200 −1.347 0.1781 0.2671 ns
reported_rn_staffing_hours_per_resident_per_day aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 193 200 −1.069 0.2849 0.3419 ns
reported_lpn_staffing_hours_per_resident_per_day aco_adopter_type Never participated Early adopter (2021-2022) 11,877 354 1.036 0.3002 0.9623 ns
reported_lpn_staffing_hours_per_resident_per_day aco_adopter_type Never participated Mid adopter (2023-2024) 11,877 193 0.7200 0.4715 0.9623 ns
reported_lpn_staffing_hours_per_resident_per_day aco_adopter_type Never participated Late adopter (2025-2026) 11,877 200 0.07392 0.9411 0.9676 ns
reported_lpn_staffing_hours_per_resident_per_day aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 354 193 −0.04059 0.9676 0.9676 ns
reported_lpn_staffing_hours_per_resident_per_day aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 354 200 −0.5721 0.5672 0.9623 ns
reported_lpn_staffing_hours_per_resident_per_day aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 193 200 −0.4656 0.6415 0.9623 ns
reported_nurse_aide_staffing_hours_per_resident_per_day aco_adopter_type Never participated Early adopter (2021-2022) 11,877 354 5.350 0.00000008808 0.0000002642 ****
reported_nurse_aide_staffing_hours_per_resident_per_day aco_adopter_type Never participated Mid adopter (2023-2024) 11,877 193 6.055 0.000000001400 0.000000008400 ****
reported_nurse_aide_staffing_hours_per_resident_per_day aco_adopter_type Never participated Late adopter (2025-2026) 11,877 200 3.030 0.002448 0.004896 **
reported_nurse_aide_staffing_hours_per_resident_per_day aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 354 193 1.686 0.09178 0.1101 ns
reported_nurse_aide_staffing_hours_per_resident_per_day aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 354 200 −0.8198 0.4124 0.4124 ns
reported_nurse_aide_staffing_hours_per_resident_per_day aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 193 200 −2.214 0.02684 0.04026 *
reported_licensed_staffing_hours_per_resident_per_day aco_adopter_type Never participated Early adopter (2021-2022) 11,877 354 7.078 0.000000000001459 0.000000000008755 ****
reported_licensed_staffing_hours_per_resident_per_day aco_adopter_type Never participated Mid adopter (2023-2024) 11,877 193 5.077 0.0000003829 0.000001149 ****
reported_licensed_staffing_hours_per_resident_per_day aco_adopter_type Never participated Late adopter (2025-2026) 11,877 200 3.691 0.0002230 0.0004461 ***
reported_licensed_staffing_hours_per_resident_per_day aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 354 193 −0.1492 0.8814 0.8814 ns
reported_licensed_staffing_hours_per_resident_per_day aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 354 200 −1.340 0.1801 0.2702 ns
reported_licensed_staffing_hours_per_resident_per_day aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 193 200 −1.043 0.2971 0.3565 ns
total_patient_revenue_gross aco_adopter_type Never participated Early adopter (2021-2022) 12,064 361 8.357 0.00000000000000006451 0.0000000000000003871 ****
total_patient_revenue_gross aco_adopter_type Never participated Mid adopter (2023-2024) 12,064 199 1.870 0.06143 0.09214 ns
total_patient_revenue_gross aco_adopter_type Never participated Late adopter (2025-2026) 12,064 202 4.267 0.00001977 0.00005930 ****
total_patient_revenue_gross aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 361 199 −3.541 0.0003979 0.0007958 ***
total_patient_revenue_gross aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 361 202 −1.634 0.1022 0.1022 ns
total_patient_revenue_gross aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 199 202 1.693 0.09047 0.1022 ns
net_patient_service_revenue aco_adopter_type Never participated Early adopter (2021-2022) 12,064 361 8.526 0.00000000000000001515 0.00000000000000009088 ****
net_patient_service_revenue aco_adopter_type Never participated Mid adopter (2023-2024) 12,064 199 1.988 0.04676 0.07015 ns
net_patient_service_revenue aco_adopter_type Never participated Late adopter (2025-2026) 12,064 202 4.629 0.000003677 0.00001103 ****
net_patient_service_revenue aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 361 199 −3.548 0.0003876 0.0007752 ***
net_patient_service_revenue aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 361 202 −1.445 0.1483 0.1483 ns
net_patient_service_revenue aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 199 202 1.865 0.06216 0.07460 ns
total_other_income aco_adopter_type Never participated Early adopter (2021-2022) 12,064 361 9.648 0.0000000000000000000005034 0.000000000000000000003020 ****
total_other_income aco_adopter_type Never participated Mid adopter (2023-2024) 12,064 199 4.086 0.00004379 0.00008759 ****
total_other_income aco_adopter_type Never participated Late adopter (2025-2026) 12,064 202 4.893 0.0000009911 0.000002973 ****
total_other_income aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 361 199 −2.529 0.01145 0.01718 *
total_other_income aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 361 202 −1.914 0.05568 0.06681 ns
total_other_income aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 199 202 0.5517 0.5811 0.5811 ns
net_income_from_patient_services aco_adopter_type Never participated Early adopter (2021-2022) 12,068 361 −4.666 0.000003067 0.00001840 ****
net_income_from_patient_services aco_adopter_type Never participated Mid adopter (2023-2024) 12,068 199 −0.9167 0.3593 0.5389 ns
net_income_from_patient_services aco_adopter_type Never participated Late adopter (2025-2026) 12,068 202 −0.4365 0.6624 0.7294 ns
net_income_from_patient_services aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 361 199 2.081 0.03744 0.07488 ns
net_income_from_patient_services aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 361 202 2.484 0.01299 0.03896 *
net_income_from_patient_services aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 199 202 0.3459 0.7294 0.7294 ns
total_operating_expenses aco_adopter_type Never participated Early adopter (2021-2022) 12,067 361 9.433 0.000000000000000000003991 0.00000000000000000002395 ****
total_operating_expenses aco_adopter_type Never participated Mid adopter (2023-2024) 12,067 199 1.925 0.05426 0.06511 ns
total_operating_expenses aco_adopter_type Never participated Late adopter (2025-2026) 12,067 202 4.454 0.000008411 0.00002523 ****
total_operating_expenses aco_adopter_type Early adopter (2021-2022) Mid adopter (2023-2024) 361 199 −4.148 0.00003347 0.00006693 ****
total_operating_expenses aco_adopter_type Early adopter (2021-2022) Late adopter (2025-2026) 361 202 −2.137 0.03256 0.04884 *
total_operating_expenses aco_adopter_type Mid adopter (2023-2024) Late adopter (2025-2026) 199 202 1.787 0.07397 0.07397 ns
Table A9. Standardized mean differences vs. never-participated
outcome group reference n_group n_ref smd ci_lo ci_hi domain label
qm_pressure_ulcers_ls Participating as of 2026 Never participated 473 12,057 −0.1419 −0.2338 −0.04998 Quality (MDS rates) Pressure ulcers, % long-stay residents
qm_pressure_ulcers_ls Exited before 2026 Never participated 278 12,057 −0.02633 −0.1452 0.09257 Quality (MDS rates) Pressure ulcers, % long-stay residents
qm_falls_major_inj_ls Participating as of 2026 Never participated 473 12,060 0.03315 −0.05872 0.1250 Quality (MDS rates) Falls with major injury, % long-stay residents
qm_falls_major_inj_ls Exited before 2026 Never participated 278 12,060 0.03339 −0.08551 0.1523 Quality (MDS rates) Falls with major injury, % long-stay residents
qm_uti_ls Participating as of 2026 Never participated 473 12,057 0.1134 0.02152 0.2053 Quality (MDS rates) Urinary tract infection, % long-stay residents
qm_uti_ls Exited before 2026 Never participated 278 12,057 0.04771 −0.07119 0.1666 Quality (MDS rates) Urinary tract infection, % long-stay residents
qm_antipsychotic_ls Participating as of 2026 Never participated 465 11,846 −0.2535 −0.3462 −0.1608 Quality (MDS rates) Antipsychotic use, % long-stay residents
qm_antipsychotic_ls Exited before 2026 Never participated 270 11,846 −0.2010 −0.3217 −0.08037 Quality (MDS rates) Antipsychotic use, % long-stay residents
qm_antipsychotic_new_ss Participating as of 2026 Never participated 488 11,697 −0.2701 −0.3607 −0.1794 Quality (MDS rates) New antipsychotic use, % short-stay residents
qm_antipsychotic_new_ss Exited before 2026 Never participated 278 11,697 −0.07891 −0.1979 0.04004 Quality (MDS rates) New antipsychotic use, % short-stay residents
overall_rating Participating as of 2026 Never participated 491 12,184 0.8449 0.7541 0.9357 Star ratings Overall star rating
overall_rating Exited before 2026 Never participated 285 12,184 −0.04397 −0.1614 0.07348 Star ratings Overall star rating
health_inspection_rating Participating as of 2026 Never participated 491 12,184 0.7182 0.6276 0.8089 Star ratings Health inspection star rating
health_inspection_rating Exited before 2026 Never participated 285 12,184 −0.1026 −0.2200 0.01490 Star ratings Health inspection star rating
staffing_rating Participating as of 2026 Never participated 487 12,143 0.5819 0.4910 0.6728 Star ratings Staffing Rating
staffing_rating Exited before 2026 Never participated 284 12,143 0.1798 0.06214 0.2975 Star ratings Staffing Rating
qm_rating Participating as of 2026 Never participated 489 12,136 0.4171 0.3265 0.5076 Star ratings Quality measure star rating
qm_rating Exited before 2026 Never participated 284 12,136 0.1316 0.01388 0.2492 Star ratings Quality measure star rating
long_stay_qm_rating Participating as of 2026 Never participated 468 11,918 0.2451 0.1527 0.3375 Star ratings Long-stay QM star rating
long_stay_qm_rating Exited before 2026 Never participated 276 11,918 0.09510 −0.02424 0.2144 Star ratings Long-stay QM star rating
short_stay_qm_rating Participating as of 2026 Never participated 467 10,303 0.4649 0.3719 0.5578 Star ratings Short-stay QM star rating
short_stay_qm_rating Exited before 2026 Never participated 262 10,303 0.1413 0.01865 0.2639 Star ratings Short-stay QM star rating
reported_rn_staffing_hours_per_resident_per_day Participating as of 2026 Never participated 474 11,877 0.4033 0.3113 0.4952 Staffing hours RN hours per resident-day (reported)
reported_rn_staffing_hours_per_resident_per_day Exited before 2026 Never participated 273 11,877 0.1207 0.0006847 0.2407 Staffing hours RN hours per resident-day (reported)
reported_lpn_staffing_hours_per_resident_per_day Participating as of 2026 Never participated 474 11,877 0.07197 −0.01984 0.1638 Staffing hours LPN hours per resident-day (reported)
reported_lpn_staffing_hours_per_resident_per_day Exited before 2026 Never participated 273 11,877 0.001849 −0.1181 0.1218 Staffing hours LPN hours per resident-day (reported)
reported_nurse_aide_staffing_hours_per_resident_per_day Participating as of 2026 Never participated 474 11,877 0.3848 0.2928 0.4767 Staffing hours Nurse aide hours per resident-day (reported)
reported_nurse_aide_staffing_hours_per_resident_per_day Exited before 2026 Never participated 273 11,877 0.08293 −0.03706 0.2029 Staffing hours Nurse aide hours per resident-day (reported)
reported_licensed_staffing_hours_per_resident_per_day Participating as of 2026 Never participated 474 11,877 0.4037 0.3117 0.4956 Staffing hours Total licensed nurse hours per resident-day (reported)
reported_licensed_staffing_hours_per_resident_per_day Exited before 2026 Never participated 273 11,877 0.1023 −0.01771 0.2223 Staffing hours Total licensed nurse hours per resident-day (reported)
total_patient_revenue_gross Participating as of 2026 Never participated 485 12,064 0.2904 0.1995 0.3812 Financial Total patient revenue (GROSS), $
total_patient_revenue_gross Exited before 2026 Never participated 277 12,064 0.2145 0.09537 0.3336 Financial Total patient revenue (GROSS), $
net_patient_service_revenue Participating as of 2026 Never participated 485 12,064 0.3087 0.2178 0.3995 Financial Net patient service revenue, $
net_patient_service_revenue Exited before 2026 Never participated 277 12,064 0.1974 0.07830 0.3166 Financial Net patient service revenue, $
total_other_income Participating as of 2026 Never participated 485 12,064 0.2819 0.1911 0.3727 Financial Total other income, $
total_other_income Exited before 2026 Never participated 277 12,064 0.09152 −0.02759 0.2106 Financial Total other income, $
net_income_from_patient_services Participating as of 2026 Never participated 485 12,068 −0.2287 −0.3195 −0.1379 Financial Net income from patient services, $
net_income_from_patient_services Exited before 2026 Never participated 277 12,068 −0.09216 −0.2113 0.02695 Financial Net income from patient services, $
total_operating_expenses Participating as of 2026 Never participated 485 12,067 0.3485 0.2576 0.4394 Financial Total operating expenses, $
total_operating_expenses Exited before 2026 Never participated 277 12,067 0.2081 0.08894 0.3272 Financial Total operating expenses, $
Table A10. Matched sample: treated facilities and controls by event type
event n_matched_pairs n_treated n_unique_controls pairs_county pairs_state
Entries 984 246 857 780 204
Exits 840 210 779 652 188
4 controls per treated, same county with state fallback (H0c).
Table A11. Operating expenses per patient day: TWFE vs. CS vs. SA vs. Stacked DID
Model Event ATT SE
TWFE Entries −2.068 13.56
Callaway-Sant'Anna Entries −21.68 36.27
Sun-Abraham Entries −51.21 40.08
Stacked DID Entries −22.19 10.52
TWFE Exits −6.453 10.54
Callaway-Sant'Anna Exits 26.13 18.68
Sun-Abraham Exits 19.25 12.48
Stacked DID Exits 2.254 8.575
Table A12. Stacked DID ATTs, all five outcomes
Outcome Event ATT SE
Total operating expenses per patient day Entries −22.19 10.52
Total operating expenses per patient day Exits 2.254 8.575
Net patient revenue per patient day Entries −8.362 10.91
Net patient revenue per patient day Exits 4.985 13.30
Gross patient revenue per patient day Entries −23.91 12.75
Gross patient revenue per patient day Exits −5.679 15.21
Net income from patient services per patient day Entries 12.35 9.315
Net income from patient services per patient day Exits −4.289 6.233
Total other income Entries 418,400 266,600
Total other income Exits −63,670 187,800
Matched sample, facility-clustered SEs.
Table A13. Event-study coefficients, all outcomes
Outcome ATT SE ci_lo ci_hi p_value p_fmt n_post_periods
Total operating expenses per patient day −22.19 10.52 −42.80 −1.568 0.03494 0.035 3
Net patient revenue per patient day −8.362 10.91 −29.74 13.01 0.4432 0.443 3
Gross patient revenue per patient day −23.91 12.75 −48.90 1.066 0.06060 0.061 3
Net income from patient services per patient day 12.35 9.315 −5.910 30.61 0.1850 0.185 3
Total other income 418,400 266,600 −104,100 940,900 0.1165 0.117 3
Table A14. Joint Wald pre-trend tests, Stacked DID
Outcome Event n_pre_coefs F_stat df1 df2 p_value pretrend_flag
Total operating expenses per patient day Entries 4 1.189 4 2,093 0.3135 Pass -- no evidence against parallel pre-trends
Total operating expenses per patient day Exits 2 2.021 2 840 0.1332 Pass -- no evidence against parallel pre-trends
Net patient revenue per patient day Entries 4 0.4237 4 2,092 0.7916 Pass -- no evidence against parallel pre-trends
Net patient revenue per patient day Exits 2 0.5216 2 840 0.5938 Pass -- no evidence against parallel pre-trends
Gross patient revenue per patient day Entries 4 0.6815 4 2,092 0.6048 Pass -- no evidence against parallel pre-trends
Gross patient revenue per patient day Exits 2 0.09432 2 840 0.9100 Pass -- no evidence against parallel pre-trends
Net income from patient services per patient day Entries 4 1.169 4 2,093 0.3223 Pass -- no evidence against parallel pre-trends
Net income from patient services per patient day Exits 2 0.8816 2 840 0.4145 Pass -- no evidence against parallel pre-trends
Total other income Entries 4 1.223 4 2,092 0.2989 Pass -- no evidence against parallel pre-trends
Total other income Exits 2 3.224 2 840 0.04030 FAIL -- reject parallel pre-trends (p < .05)
p < .05 flags doubtful parallel pre-trends.
Table A15. Honest DiD breakdown values (relative magnitudes)
Outcome Event breakdown_Mbar note
Total operating expenses per patient day Entries 0 ok
Total operating expenses per patient day Exits 0 ok
Net patient revenue per patient day Entries 0 ok
Net patient revenue per patient day Exits 0 ok
Gross patient revenue per patient day Entries 0 ok
Gross patient revenue per patient day Exits 0 ok
Net income from patient services per patient day Entries 0.5000 ok
Net income from patient services per patient day Exits 0 ok
Total other income Entries 0 ok
Total other income Exits 0 ok
Rambachan & Roth (2023).
Table A16. Per-day outcome winsorization cutoffs (pooled 1/99, robustness)
outcome p01 p99
opex_per_day 199.5 2,121
patient_rev_net_per_day 190.9 1,621
patient_rev_gross_per_day 206.4 1,848
patient_netinc_per_day −848.7 96.96
total_other_income −37,590 17,920,000
Table A17. Raw vs. winsorized ATTs (robustness)
Outcome Event Version ATT SE
Total operating expenses per patient day Entries Raw −22.19 10.52
Total operating expenses per patient day Entries Winsorized 4.563 7.863
Total operating expenses per patient day Exits Raw 2.254 8.575
Total operating expenses per patient day Exits Winsorized 5.694 10.56
Net patient revenue per patient day Entries Raw −8.362 10.91
Net patient revenue per patient day Entries Winsorized 12.18 5.557
Net patient revenue per patient day Exits Raw 4.985 13.30
Net patient revenue per patient day Exits Winsorized 6.244 7.337
Gross patient revenue per patient day Entries Raw −23.91 12.75
Gross patient revenue per patient day Entries Winsorized 2.608 7.084
Gross patient revenue per patient day Exits Raw −5.679 15.21
Gross patient revenue per patient day Exits Winsorized −3.324 9.148
Net income from patient services per patient day Entries Raw 12.35 9.315
Net income from patient services per patient day Entries Winsorized −1.310 5.124
Net income from patient services per patient day Exits Raw −4.289 6.233
Net income from patient services per patient day Exits Winsorized −2.369 4.722
Total other income Entries Raw 418,400 266,600
Total other income Entries Winsorized 24,150 112,500
Total other income Exits Raw −63,670 187,800
Total other income Exits Winsorized 46,720 105,800
Table A18. Pre-trend tests on winsorized outcomes (robustness)
Outcome Event n_pre_coefs F_stat df1 df2 p_value pretrend_flag
Total operating expenses per patient day Entries 4 2.205 4 3,840 0.06599 Pass -- no evidence against parallel pre-trends
Total operating expenses per patient day Exits 2 0.06727 2 1,503 0.9349 Pass -- no evidence against parallel pre-trends
Net patient revenue per patient day Entries 4 1.418 4 3,839 0.2254 Pass -- no evidence against parallel pre-trends
Net patient revenue per patient day Exits 2 0.1719 2 1,502 0.8421 Pass -- no evidence against parallel pre-trends
Gross patient revenue per patient day Entries 4 1.436 4 3,839 0.2195 Pass -- no evidence against parallel pre-trends
Gross patient revenue per patient day Exits 2 0.09104 2 1,501 0.9130 Pass -- no evidence against parallel pre-trends
Net income from patient services per patient day Entries 4 0.4306 4 3,840 0.7866 Pass -- no evidence against parallel pre-trends
Net income from patient services per patient day Exits 2 0.3330 2 1,503 0.7168 Pass -- no evidence against parallel pre-trends
Total other income Entries 4 1.689 4 3,731 0.1497 Pass -- no evidence against parallel pre-trends
Total other income Exits 2 3.433 2 1,453 0.03257 FAIL -- reject parallel pre-trends (p < .05)
Table A19. Honest DiD on winsorized outcomes (robustness)
Outcome Event breakdown_Mbar note
Total operating expenses per patient day Entries 0 ok
Total operating expenses per patient day Exits 0 ok
Net patient revenue per patient day Entries 0 ok
Net patient revenue per patient day Exits 0 ok
Gross patient revenue per patient day Entries 0 ok
Gross patient revenue per patient day Exits 0 ok
Net income from patient services per patient day Entries 0 ok
Net income from patient services per patient day Exits 0 ok
Total other income Entries 0 ok
Total other income Exits 0 ok

Figures

Aco entry timeline
Figure A1. Aco entry timeline (fig_aco_entry_timeline.png)
Participation duration
Figure A2. Participation duration (fig_participation_duration.png)
Sankey participation patterns
Figure A3. Sankey participation patterns (fig_sankey_participation_patterns.png)
Smd forest vs never participated
Figure A4. Smd forest vs never participated (fig_smd_forest_vs_never_participated.png)
Snf aco participation line
Figure A5. Snf aco participation line (fig_snf_aco_participation_line.png)
Star ratings by treatment
Figure A6. Star ratings by treatment (fig_star_ratings_by_treatment.png)
Treatment group counts
Figure A7. Treatment group counts (fig_treatment_group_counts.png)
Snf aco dots
Figure A8. Snf aco dots (map_snf_aco_dots.png)
Unadjusted trend entries grossday calendar
Figure A9. Unadjusted trend entries grossday calendar (fig_unadjusted_trend_entries_grossday_calendar.png)
Unadjusted trend entries grossday event
Figure A10. Unadjusted trend entries grossday event (fig_unadjusted_trend_entries_grossday_event.png)
Unadjusted trend entries netinc calendar
Figure A11. Unadjusted trend entries netinc calendar (fig_unadjusted_trend_entries_netinc_calendar.png)
Unadjusted trend entries netinc event
Figure A12. Unadjusted trend entries netinc event (fig_unadjusted_trend_entries_netinc_event.png)
Unadjusted trend entries opex calendar
Figure A13. Unadjusted trend entries opex calendar (fig_unadjusted_trend_entries_opex_calendar.png)
Unadjusted trend entries opex event
Figure A14. Unadjusted trend entries opex event (fig_unadjusted_trend_entries_opex_event.png)
Unadjusted trend entries otherinc calendar
Figure A15. Unadjusted trend entries otherinc calendar (fig_unadjusted_trend_entries_otherinc_calendar.png)
Unadjusted trend entries otherinc event
Figure A16. Unadjusted trend entries otherinc event (fig_unadjusted_trend_entries_otherinc_event.png)
Unadjusted trend entries revday calendar
Figure A17. Unadjusted trend entries revday calendar (fig_unadjusted_trend_entries_revday_calendar.png)
Unadjusted trend entries revday event
Figure A18. Unadjusted trend entries revday event (fig_unadjusted_trend_entries_revday_event.png)
Unadjusted trend entries rn calendar
Figure A19. Unadjusted trend entries rn calendar (fig_unadjusted_trend_entries_rn_calendar.png)
Unadjusted trend entries rn event
Figure A20. Unadjusted trend entries rn event (fig_unadjusted_trend_entries_rn_event.png)
Unadjusted trend exits grossday calendar
Figure A21. Unadjusted trend exits grossday calendar (fig_unadjusted_trend_exits_grossday_calendar.png)
Unadjusted trend exits grossday event
Figure A22. Unadjusted trend exits grossday event (fig_unadjusted_trend_exits_grossday_event.png)
Unadjusted trend exits netinc calendar
Figure A23. Unadjusted trend exits netinc calendar (fig_unadjusted_trend_exits_netinc_calendar.png)
Unadjusted trend exits netinc event
Figure A24. Unadjusted trend exits netinc event (fig_unadjusted_trend_exits_netinc_event.png)
Unadjusted trend exits opex calendar
Figure A25. Unadjusted trend exits opex calendar (fig_unadjusted_trend_exits_opex_calendar.png)
Unadjusted trend exits opex event
Figure A26. Unadjusted trend exits opex event (fig_unadjusted_trend_exits_opex_event.png)
Unadjusted trend exits otherinc calendar
Figure A27. Unadjusted trend exits otherinc calendar (fig_unadjusted_trend_exits_otherinc_calendar.png)
Unadjusted trend exits otherinc event
Figure A28. Unadjusted trend exits otherinc event (fig_unadjusted_trend_exits_otherinc_event.png)
Unadjusted trend exits revday calendar
Figure A29. Unadjusted trend exits revday calendar (fig_unadjusted_trend_exits_revday_calendar.png)
Unadjusted trend exits revday event
Figure A30. Unadjusted trend exits revday event (fig_unadjusted_trend_exits_revday_event.png)
Unadjusted trend exits rn calendar
Figure A31. Unadjusted trend exits rn calendar (fig_unadjusted_trend_exits_rn_calendar.png)
Unadjusted trend exits rn event
Figure A32. Unadjusted trend exits rn event (fig_unadjusted_trend_exits_rn_event.png)
Unadjusted trends entries combined all outcomes
Figure A33. Unadjusted trends entries combined all outcomes (fig_unadjusted_trends_entries_combined_all_outcomes.png)
Event study entries operating expenses
Figure A34. Event study entries operating expenses (fig_event_study_entries_operating_expenses.png)
Event study entries operating expenses per day
Figure A35. Event study entries operating expenses per day (fig_event_study_entries_operating_expenses_per_day.png)
Event study exits operating expenses
Figure A36. Event study exits operating expenses (fig_event_study_exits_operating_expenses.png)
Event study exits operating expenses per day
Figure A37. Event study exits operating expenses per day (fig_event_study_exits_operating_expenses_per_day.png)
Stacked did entries all outcomes
Figure A38. Stacked did entries all outcomes (fig_stacked_did_entries_all_outcomes.png)
Stacked did entries combined all outcomes
Figure A39. Stacked did entries combined all outcomes (fig_stacked_did_entries_combined_all_outcomes.png)
Stacked did exits all outcomes
Figure A40. Stacked did exits all outcomes (fig_stacked_did_exits_all_outcomes.png)
Honest did entries grossday
Figure A41. Honest did entries grossday (fig_honest_did_entries_grossday.png)
Honest did entries netinc
Figure A42. Honest did entries netinc (fig_honest_did_entries_netinc.png)
Honest did entries opex
Figure A43. Honest did entries opex (fig_honest_did_entries_opex.png)
Honest did entries otherinc
Figure A44. Honest did entries otherinc (fig_honest_did_entries_otherinc.png)
Honest did entries revday
Figure A45. Honest did entries revday (fig_honest_did_entries_revday.png)
Honest did exits grossday
Figure A46. Honest did exits grossday (fig_honest_did_exits_grossday.png)
Honest did exits netinc
Figure A47. Honest did exits netinc (fig_honest_did_exits_netinc.png)
Honest did exits opex
Figure A48. Honest did exits opex (fig_honest_did_exits_opex.png)
Honest did exits otherinc
Figure A49. Honest did exits otherinc (fig_honest_did_exits_otherinc.png)
Honest did exits revday
Figure A50. Honest did exits revday (fig_honest_did_exits_revday.png)
Honest did entries grossday winsorized
Figure A51. Honest did entries grossday winsorized (fig_honest_did_entries_grossday_winsorized.png)
Honest did entries netinc winsorized
Figure A52. Honest did entries netinc winsorized (fig_honest_did_entries_netinc_winsorized.png)
Honest did entries opex winsorized
Figure A53. Honest did entries opex winsorized (fig_honest_did_entries_opex_winsorized.png)
Honest did entries otherinc winsorized
Figure A54. Honest did entries otherinc winsorized (fig_honest_did_entries_otherinc_winsorized.png)
Honest did entries revday winsorized
Figure A55. Honest did entries revday winsorized (fig_honest_did_entries_revday_winsorized.png)
Honest did exits grossday winsorized
Figure A56. Honest did exits grossday winsorized (fig_honest_did_exits_grossday_winsorized.png)
Honest did exits netinc winsorized
Figure A57. Honest did exits netinc winsorized (fig_honest_did_exits_netinc_winsorized.png)
Honest did exits opex winsorized
Figure A58. Honest did exits opex winsorized (fig_honest_did_exits_opex_winsorized.png)
Honest did exits otherinc winsorized
Figure A59. Honest did exits otherinc winsorized (fig_honest_did_exits_otherinc_winsorized.png)
Honest did exits revday winsorized
Figure A60. Honest did exits revday winsorized (fig_honest_did_exits_revday_winsorized.png)
Stacked did entries all outcomes winsorized
Figure A61. Stacked did entries all outcomes winsorized (fig_stacked_did_entries_all_outcomes_winsorized.png)
Stacked did entries grossday winsorized
Figure A62. Stacked did entries grossday winsorized (fig_stacked_did_entries_grossday_winsorized.png)
Stacked did entries netinc winsorized
Figure A63. Stacked did entries netinc winsorized (fig_stacked_did_entries_netinc_winsorized.png)
Stacked did entries opex winsorized
Figure A64. Stacked did entries opex winsorized (fig_stacked_did_entries_opex_winsorized.png)
Stacked did entries otherinc winsorized
Figure A65. Stacked did entries otherinc winsorized (fig_stacked_did_entries_otherinc_winsorized.png)
Stacked did entries revday winsorized
Figure A66. Stacked did entries revday winsorized (fig_stacked_did_entries_revday_winsorized.png)
Stacked did exits all outcomes winsorized
Figure A67. Stacked did exits all outcomes winsorized (fig_stacked_did_exits_all_outcomes_winsorized.png)
Stacked did exits grossday winsorized
Figure A68. Stacked did exits grossday winsorized (fig_stacked_did_exits_grossday_winsorized.png)
Stacked did exits netinc winsorized
Figure A69. Stacked did exits netinc winsorized (fig_stacked_did_exits_netinc_winsorized.png)
Stacked did exits opex winsorized
Figure A70. Stacked did exits opex winsorized (fig_stacked_did_exits_opex_winsorized.png)
Stacked did exits otherinc winsorized
Figure A71. Stacked did exits otherinc winsorized (fig_stacked_did_exits_otherinc_winsorized.png)
Stacked did exits revday winsorized
Figure A72. Stacked did exits revday winsorized (fig_stacked_did_exits_revday_winsorized.png)
Unadjusted trend entries grossday calendar winsorized
Figure A73. Unadjusted trend entries grossday calendar winsorized (fig_unadjusted_trend_entries_grossday_calendar_winsorized.png)
Unadjusted trend entries grossday event winsorized
Figure A74. Unadjusted trend entries grossday event winsorized (fig_unadjusted_trend_entries_grossday_event_winsorized.png)
Unadjusted trend entries netinc calendar winsorized
Figure A75. Unadjusted trend entries netinc calendar winsorized (fig_unadjusted_trend_entries_netinc_calendar_winsorized.png)
Unadjusted trend entries netinc event winsorized
Figure A76. Unadjusted trend entries netinc event winsorized (fig_unadjusted_trend_entries_netinc_event_winsorized.png)
Unadjusted trend entries opex calendar winsorized
Figure A77. Unadjusted trend entries opex calendar winsorized (fig_unadjusted_trend_entries_opex_calendar_winsorized.png)
Unadjusted trend entries opex event winsorized
Figure A78. Unadjusted trend entries opex event winsorized (fig_unadjusted_trend_entries_opex_event_winsorized.png)
Unadjusted trend entries otherinc calendar winsorized
Figure A79. Unadjusted trend entries otherinc calendar winsorized (fig_unadjusted_trend_entries_otherinc_calendar_winsorized.png)
Unadjusted trend entries otherinc event winsorized
Figure A80. Unadjusted trend entries otherinc event winsorized (fig_unadjusted_trend_entries_otherinc_event_winsorized.png)
Unadjusted trend entries revday calendar winsorized
Figure A81. Unadjusted trend entries revday calendar winsorized (fig_unadjusted_trend_entries_revday_calendar_winsorized.png)
Unadjusted trend entries revday event winsorized
Figure A82. Unadjusted trend entries revday event winsorized (fig_unadjusted_trend_entries_revday_event_winsorized.png)
Unadjusted trend exits grossday calendar winsorized
Figure A83. Unadjusted trend exits grossday calendar winsorized (fig_unadjusted_trend_exits_grossday_calendar_winsorized.png)
Unadjusted trend exits grossday event winsorized
Figure A84. Unadjusted trend exits grossday event winsorized (fig_unadjusted_trend_exits_grossday_event_winsorized.png)
Unadjusted trend exits netinc calendar winsorized
Figure A85. Unadjusted trend exits netinc calendar winsorized (fig_unadjusted_trend_exits_netinc_calendar_winsorized.png)
Unadjusted trend exits netinc event winsorized
Figure A86. Unadjusted trend exits netinc event winsorized (fig_unadjusted_trend_exits_netinc_event_winsorized.png)
Unadjusted trend exits opex calendar winsorized
Figure A87. Unadjusted trend exits opex calendar winsorized (fig_unadjusted_trend_exits_opex_calendar_winsorized.png)
Unadjusted trend exits opex event winsorized
Figure A88. Unadjusted trend exits opex event winsorized (fig_unadjusted_trend_exits_opex_event_winsorized.png)
Unadjusted trend exits otherinc calendar winsorized
Figure A89. Unadjusted trend exits otherinc calendar winsorized (fig_unadjusted_trend_exits_otherinc_calendar_winsorized.png)
Unadjusted trend exits otherinc event winsorized
Figure A90. Unadjusted trend exits otherinc event winsorized (fig_unadjusted_trend_exits_otherinc_event_winsorized.png)
Unadjusted trend exits revday calendar winsorized
Figure A91. Unadjusted trend exits revday calendar winsorized (fig_unadjusted_trend_exits_revday_calendar_winsorized.png)
Unadjusted trend exits revday event winsorized
Figure A92. Unadjusted trend exits revday event winsorized (fig_unadjusted_trend_exits_revday_event_winsorized.png)