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Medicare payment changes and nursing home quality: effects on long-stay residents

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  • R. Konetzka
  • Edward Norton
  • Sally Stearns

Abstract

The Balanced Budget Act of 1997 dramatically changed the way that Medicare pays skilled nursing facilities, providing a natural experiment in nursing home behavior. Medicare payment policy (directed at short-stay residents) may have affected outcomes for long-stay, chronic-care residents if services for these residents were subsidized through cost-shifting prior to implementation of Medicare prospective payment for nursing homes. We link changes in both the form and level of Medicare payment at the facility level with changes in resident-level quality, as represented by pressure sores and urinary tract infections in Minimum Data Set (MDS) assessments. Results show that long-stay residents experienced increased adverse outcomes with the elimination of Medicare cost reimbursement. Copyright Springer Science+Business Media, LLC 2006

Suggested Citation

  • R. Konetzka & Edward Norton & Sally Stearns, 2006. "Medicare payment changes and nursing home quality: effects on long-stay residents," International Journal of Health Economics and Management, Springer, vol. 6(3), pages 173-189, September.
    • Handle: RePEc:kap:ijhcfe:v:6:y:2006:i:3:p:173-189
    DOI: 10.1007/s10754-006-9000-9
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    References listed on IDEAS

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    Cited by:

    1. Arndt R. Reichert & Magdalena A. Stroka, 2018. "Nursing home prices and quality of care — Evidence from administrative data," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 129-140, January.
    2. Christopher Afendulis & Daniel Kessler, 2011. "Vertical Integration and Optimal Reimbursement Policy," NBER Working Papers 17316, National Bureau of Economic Research, Inc.
    3. Christopher Brunt & Gail Jensen, 2010. "Medicare Part B reimbursement and the perceived quality of physician care," International Journal of Health Economics and Management, Springer, vol. 10(2), pages 149-170, June.
    4. Grabowski, David C. & Afendulis, Christopher C. & McGuire, Thomas G., 2011. "Medicare prospective payment and the volume and intensity of skilled nursing facility services," Journal of Health Economics, Elsevier, vol. 30(4), pages 675-684, July.
    5. Arndt R. Reicher & Magdalena Stroka, 2014. "Nursing Home Prices and Quality of Care - Evidence from Administrative Data," Ruhr Economic Papers 0470, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    6. repec:zbw:rwirep:0470 is not listed on IDEAS
    7. Cutler, Henry & Gu, Yuanyuan & Bilgrami, Anam & Partington, Andrew, 2023. "The 2021 proposal to increase market forces in the Australian residential aged-care sector," Health Policy, Elsevier, vol. 127(C), pages 60-65.
    8. Christopher S. Brunt & Gail A. Jensen, 2014. "Pricing Distortions In Medicare'S Physician Fee Schedule And Patient Satisfaction With Care Quality And Access," Health Economics, John Wiley & Sons, Ltd., vol. 23(7), pages 761-775, July.
    9. Jeongyoung Park & Rachel M. Werner, 2011. "Changes in the relationship between nursing home financial performance and quality of care under public reporting," Health Economics, John Wiley & Sons, Ltd., vol. 20(7), pages 783-801, July.
    10. Templeton, Zachary S. & Apathy, Nate C. & Konetzka, R. Tamara & Skira, Meghan M. & Werner, Rachel M., 2023. "The health effects of nursing home specialization in post-acute care," Journal of Health Economics, Elsevier, vol. 92(C).
    11. Christopher Afendulis & Daniel Kessler, 2011. "Vertical integration and optimal reimbursement policy," International Journal of Health Economics and Management, Springer, vol. 11(3), pages 165-179, September.
    12. Van Houtven, Courtney Harold & Norton, Edward C., 2008. "Informal care and Medicare expenditures: Testing for heterogeneous treatment effects," Journal of Health Economics, Elsevier, vol. 27(1), pages 134-156, January.

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    More about this item

    Keywords

    Prospective payment; Nursing homes; Medicare; Quality of care; I11; I18; H51;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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