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The Influence of Medicare Home Health Payment Incentives: Does Payer Source Matter?

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  • David C. Grabowski,

    ()

  • David G. Stevenson
  • Haiden A. Huskamp
  • Nancy L. Keating

    (Department of Health Care Policy, Harvard Medical School)

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    Abstract

    During the late 1990s, an interim payment system (IPS) was instituted to constrain Medicare home health care expenditures. Previous research has largely focused on the implications of the IPS for Medicare patients, but our study broadens the analysis to consider patients with other payer sources. Using the National Home and Hospice Care Survey, we found similar effects of the IPS across payer types. Specifically, the IPS was associated with a decrease in access to care for the sickest patients, less agency assistance with activities of daily living, and shorter length-of-use. However, these changes did not translate into worse discharge outcomes.

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    Bibliographic Info

    Paper provided by Program on the Global Demography of Aging in its series PGDA Working Papers with number 0605.

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    Date of creation: Sep 2005
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    Handle: RePEc:gdm:wpaper:0605

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    Web page: http://www.hsph.harvard.edu/pgda
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    Keywords: Medicare; health; incentives;

    References

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    1. Ai, Chunrong & Norton, Edward C., 2003. "Interaction terms in logit and probit models," Economics Letters, Elsevier, vol. 80(1), pages 123-129, July.
    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.
    3. Edward C. Norton & Hua Wang & Chunrong Ai, 2004. "Computing interaction effects and standard errors in logit and probit models," Stata Journal, StataCorp LP, vol. 4(2), pages 154-167, June.
    4. Norton, Edward C., 2000. "Long-term care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 17, pages 955-994 Elsevier.
    5. Richard G. Frank, 2004. "Behavioral Economics and Health Economics," NBER Working Papers 10881, National Bureau of Economic Research, Inc.
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