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A Longitudinal Study of Medicaid Payment, Private-Pay Price and Nursing Home Quality

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Author Info
David C. Grabowski ()
Abstract

Quality of care problems have persisted for decades within U.S. nursing homes. A potential state-level policy towards addressing this concern is the level of Medicaid payment. However, a number of studies have found that an increase in Medicaid payment is associated with lower quality in the presence of certificate-of-need (CON) laws and bed construction moratorium regulations, which serve as barriers to entry within the nursing home industry. Instead of relying on potentially confounded cross-sectional comparisons, this study presents novel, panel-based evidence that incorporates aggregate private-pay price data. These estimates almost uniformly indicate that an increase in the Medicaid payment rate raises nursing home quality. When compared to the earlier literature, these new findings are attributed to changes over time in the market for nursing home care related to the growth in nursing home substitutes.

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Publisher Info
Article provided by Springer in its journal International Journal of Health Care Finance and Economics.

Volume (Year): 4 (2004)
Issue (Month): 1 (03)
Pages: 5-26
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Handle: RePEc:kap:ijhcfe:v:4:y:2004:i:1:p:5-26

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Web page: http://www.springerlink.com/link.asp?id=106603

For technical questions regarding this item, or to correct its listing, contact: (Christopher F. Baum).

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  1. David C. Grabowski & Jonathan Gruber, 2005. "Moral Hazard in Nursing Home Use," NBER Working Papers 11723, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  2. David C. Grabowski & Jonathan Gruber & Joseph J. Angelelli, 2006. "Nursing Home Quality as a Public Good," NBER Working Papers 12361, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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This page was last updated on 2009-11-27.


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