Home care reimbursement, long-term care utilization, and health outcomes

• 成果类型: Article
• 署名作者: McKnight, R
• 署名单位: University of Oregon; National Bureau of Economic Research
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2004.11.006
• 发表日期: 2006
• 页码: 293-323
• 关键词: Medicare; prospective payment; home health care

摘要

Using a substantial change in Medicare reimbursement policy to study the market for home health care, I find that the introduction of tightly binding average per-patient reimbursement caps led to a large drop in the provision of home care, particularly to the least healthy beneficiaries. This decline in home health utilization was not offset by increases in institutional long-term care or other medical care and there were no associated adverse health consequences. However, approximately one-quarter of the decline in Medicare spending was offset by increases ill Out-of-pocket expenditures for home health care, with the offset concentrated in higher income populations. (c) 2005 Elsevier B.V. All rights reserved.