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

  • R. Konetzka

    ()

  • Edward Norton
  • Sally Stearns

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

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File URL: http://hdl.handle.net/10.1007/s10754-006-9000-9
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Article provided by Springer in its journal International Journal of Health Care Finance and Economics.

Volume (Year): 6 (2006)
Issue (Month): 3 (September)
Pages: 173-189

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Handle: RePEc:kap:ijhcfe:v:6:y:2006:i:3:p:173-189
Contact details of provider: Web page: http://www.springerlink.com/link.asp?id=106603

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  8. Nyman, John A., 1985. "Prospective and `cost-plus' medicaid reimbursement, excess medicaid demand, and the quality of nursing home care," Journal of Health Economics, Elsevier, vol. 4(3), pages 237-259, September.
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