Adequate staffing is critical to the effective operation of health care facilities. Yet, most nursing homes staff below the levels that clinicians, researchers, and advocates consider adequate. Various state and federal proposals have aimed to raise staffing through payment reforms and staffing regulations. To understand the impacts of such policies on patient health, authors study a recent Illinois payment reform aimed at increasing staffing at Medicaid-serving facilities.

Findings: In this case-control study, authors 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 6,142 fewer hospitalizations each year. While these findings are promising, they leave considerable room for further research.