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Medicaid and the Cost of Improving Access to Nursing Home Care

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  • Gertler, Paul J
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    Abstract

    The Medicaid program can improve the access of Medicaid patients in nursing home care by raising the rate of return on Medicaid patients care. However, increases in the return also induce nursing homes to lower quality. To quantify this tradeoff, the author derives expressions for three elasticities: (1) the elasticity of access with respect to Medicaid expenditures, (2) the elasticity of access with respect to quality, and (3) the elasticity of Medicaid expenditures with respect to the rate of return. Using New York State data, he finds that a 10 percent increase in Medicaid expenditures induces a 4.1 percent increase in Medicaid patient care and a reduction in nursing home expenditures on services provided patients by about 3.4 percent. Copyright 1992 by MIT Press.

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    Bibliographic Info

    Article provided by MIT Press in its journal Review of Economics & Statistics.

    Volume (Year): 74 (1992)
    Issue (Month): 2 (May)
    Pages: 338-45

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    Handle: RePEc:tpr:restat:v:74:y:1992:i:2:p:338-45

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    Web page: http://mitpress.mit.edu/journals/

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    Web: http://mitpress.mit.edu/journal-home.tcl?issn=00346535

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    Cited by:
    1. Noguchi, Haruko & Shimizutani, Satoshi, 2007. "Nonprofit/for-profit status and earning differentials in the Japanese at-home elderly care industry: Evidence from micro-level data on home helpers and staff nurses," Journal of the Japanese and International Economies, Elsevier, vol. 21(1), pages 106-120, March.
    2. Lara Gardner & Donna Gilleskie, 2006. "The Effects of State Medicaid Policies on the Dynamic Savings Patterns of the Elderly," NBER Working Papers 12208, National Bureau of Economic Research, Inc.
    3. repec:ebl:ecbull:v:9:y:2005:i:3:p:1-13 is not listed on IDEAS
    4. Arndt R. Reicher & Magdalena Stroka, 2014. "Nursing Home Prices and Quality of Care - Evidence from Administrative Data," Ruhr Economic Papers, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen 0470, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    5. Grabowski, David C., 2001. "Medicaid reimbursement and the quality of nursing home care," Journal of Health Economics, Elsevier, Elsevier, vol. 20(4), pages 549-569, July.
    6. Jonathan Gruber, 2003. "Medicaid," NBER Chapters, National Bureau of Economic Research, Inc, in: Means-Tested Transfer Programs in the United States, pages 15-78 National Bureau of Economic Research, Inc.
    7. Lin, Haizhen & Prince, Jeffrey, 2013. "The impact of the partnership long-term care insurance program on private coverage," Journal of Health Economics, Elsevier, Elsevier, vol. 32(6), pages 1205-1213.
    8. Hendrik Schmitz & Magdalena Stroka, 2014. "Do Elderly Choose Nursing Homes by Quality, Price or Location?," Ruhr Economic Papers, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen 0495, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    9. Shimizutani, Satoshi & Suzuki, Wataru, 2007. "Quality and efficiency of home help elderly care in Japan: Evidence from micro-level data," Journal of the Japanese and International Economies, Elsevier, vol. 21(2), pages 287-301, June.
    10. Hirth, Richard A., 1999. "Consumer information and competition between nonprofit and for-profit nursing homes," Journal of Health Economics, Elsevier, Elsevier, vol. 18(2), pages 219-240, April.
    11. Tor Holmås & Mohammad Kamrul Islam & Egil Kjerstad, 2013. "Between two beds: inappropriately delayed discharges from hospitals," International Journal of Health Care Finance and Economics, Springer, Springer, vol. 13(3), pages 201-217, December.
    12. Bowblis, John R. & McHone, Heather S., 2013. "An instrumental variables approach to post-acute care nursing home quality: Is there a dime's worth of evidence that continuing care retirement communities provide higher quality?," Journal of Health Economics, Elsevier, Elsevier, vol. 32(5), pages 980-996.
    13. Cohen, Joel W. & Spector, William D., 1996. "The effect of Medicaid reimbursement on quality of care in nursing homes," Journal of Health Economics, Elsevier, Elsevier, vol. 15(1), pages 23-48, February.
    14. J. Bradford Rice & Judith D. Kasper & Liliana E. Pezzin, 2009. "A comparative analysis of Medicaid long-term care policies and their effects on elderly dual enrollees," Health Economics, John Wiley & Sons, Ltd., John Wiley & Sons, Ltd., vol. 18(3), pages 275-290.
    15. Grabowski, David C. & Hirth, Richard A., 2003. "Competitive spillovers across non-profit and for-profit nursing homes," Journal of Health Economics, Elsevier, Elsevier, vol. 22(1), pages 1-22, January.

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