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Excess Demand, the Percentage of Medicaid Patients, and the Quality of Nursing Home Care

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  • John A. Nyman

Abstract

Most empirical studies of the determinants of the quality of nursing home care find a strong relationship between poor quality and a high percentage of Medicaid patients in the nursing home. These findings are often interpreted as evidence that the reimbursement rates paid for Medicaid patients are constraining nursing homes from providing higher quality care. Alternatively, this relationship can be attributed to the presence of excess demand eliminating the need to engage in quality competition for the less lucrative Medicaid patients. This paper tests these two hypotheses using Wisconsin data from 1979 and finds evidence favoring the latter.

Suggested Citation

  • John A. Nyman, 1988. "Excess Demand, the Percentage of Medicaid Patients, and the Quality of Nursing Home Care," Journal of Human Resources, University of Wisconsin Press, vol. 23(1), pages 76-92.
  • Handle: RePEc:uwp:jhriss:v:23:y:1988:i:1:p:76-92
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    Citations

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    Cited by:

    1. Reichert, Arndt R. & Stroka, Magdalena A., 2014. "Nursing Home Prices and Quality of Care - Evidence from Administrative Data," Ruhr Economic Papers 470, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    2. William J. Scanlon, 1992. "Possible Reforms for Financing Long-Term Care," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 43-58, Summer.
    3. Foster, Andrew D. & Lee, Yong Suk, 2015. "Staffing subsidies and the quality of care in nursing homes," Journal of Health Economics, Elsevier, vol. 41(C), pages 133-147.
    4. Lin, Haizhen & Prince, Jeffrey, 2013. "The impact of the partnership long-term care insurance program on private coverage," Journal of Health Economics, Elsevier, vol. 32(6), pages 1205-1213.
    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. 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.
    7. David C. Grabowski & Edward C. Norton, 2012. "Nursing Home Quality of Care," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 29 Edward Elgar Publishing.
    8. Haizhen Lin, 2010. "Do Minimum Quality Standards Improve Quality? A Case Study of the Nursing Home Industry," Working Papers 2010-01, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    9. Eika, Kari, 2003. "Low Quality-Effective Demand," Memorandum 36/2003, Oslo University, Department of Economics.
    10. Grabowski, David C., 2001. "Medicaid reimbursement and the quality of nursing home care," Journal of Health Economics, Elsevier, vol. 20(4), pages 549-569, July.
    11. Cohen, Joel W. & Spector, William D., 1996. "The effect of Medicaid reimbursement on quality of care in nursing homes," Journal of Health Economics, Elsevier, vol. 15(1), pages 23-48, February.
    12. Kesteloot, K. & Voet, N., 1998. "Incentives for cooperation in quality improvement among hospitals--the impact of the reimbursement system," Journal of Health Economics, Elsevier, vol. 17(6), pages 701-728, December.
    13. Haizhen Lin, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Working Papers 2014-01, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    14. Lin, Haizhen, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Journal of Health Economics, Elsevier, vol. 37(C), pages 13-24.
    15. repec:zbw:rwirep:0470 is not listed on IDEAS
    16. Nishimura, Y.; Oikawa, M.;, 2017. "Effects of Informal Elderly Care on Labor Supply: Exploitation of Government Intervention on the Supply Side of Elderly Care Market," Health, Econometrics and Data Group (HEDG) Working Papers 17/02, HEDG, c/o Department of Economics, University of York.
    17. 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, vol. 32(5), pages 980-996.
    18. SHIMIZUTANI Satoshi & NOGUCHI Haruko, 2002. "Earnings and Quality Differentials in For-Profit versus Nonprofit Long-Term Care: Evidence from Japan's Long-Term Care Market," ESRI Discussion paper series 017, Economic and Social Research Institute (ESRI).

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