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

International Journal of Health Care Finance and Economics volume 6, pages 173–189 (2006)Cite this article

Abstract

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.

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Affiliations

  1. Department of Health Studies, University of Chicago, 5841 S. Maryland Ave., MC2007, Chicago, IL, 60637, USA

    R. Tamara Konetzka

  2. University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7590, USA

    Edward C. Norton & Sally C. Stearns

Authors
  1. R. Tamara Konetzka
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  2. Edward C. Norton
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  3. Sally C. Stearns
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Correspondence to R. Tamara Konetzka.

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Konetzka, R.T., Norton, E.C. & Stearns, S.C. Medicare payment changes and nursing home quality: effects on long-stay residents. Int J Health Care Finance Econ 6, 173–189 (2006). https://doi.org/10.1007/s10754-006-9000-9

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  • DOI: https://doi.org/10.1007/s10754-006-9000-9

Keywords

  • Prospective payment
  • Nursing homes
  • Medicare
  • Quality of care

JEL Classification

  • I11
  • I18
  • H51