The Effect of Prospective Payment on Admission and Treatment Policy : Evidence from Inpatient Rehabilitation Facilities
Neeraj Sood, Peter J. Huckfeldt, David C. Grabowski, Joseph P. Newhouse, José J. Escarce
We examine provider responses to the Medicare inpatient rehabilitation facility (IRF) prospective payment system (PPS), which simultaneously reduced marginal reimbursement and increased average reimbursement. IRFs could respond to the PPS by changing the total number of patients admitted, admitting different types of patients, or changing the intensity of care for admitted patients. We use Medicare claims data to separately estimate each type of provider response to the PPS. We also examine changes in patient outcomes and spillover effects on other post acute care providers. We find that costs of care initially fell following the PPS implementation, which we attribute to changes in treatment decisions rather than the types of patients admitted to IRFs. However, the probability of admission to IRFs increased after the PPS due to the expanded admission policies of providers. We find modest spillover effects on skilled nursing home costs and no substantive impact on patient health outcomes
Year of publication: |
June 2011
|
---|---|
Authors: | Sood, Neeraj |
Other Persons: | Grabowski, David C. (contributor) ; Newhouse, Joseph P. (contributor) ; Escarce, José J. (contributor) ; Huckfeldt, Peter J. (contributor) |
Institutions: | National Bureau of Economic Research (contributor) |
Publisher: |
Cambridge, Mass : National Bureau of Economic Research |
Subject: | Gesundheitsversorgung | Health care | Gesundheitskosten | Health care costs | Rehabilitationseinrichtung | Rehabilitation hospital | Rückzahlung | Repayment |
Saved in:
freely available
Extent: | 1 Online-Ressource |
---|---|
Series: | NBER working paper series ; no. w17125 |
Type of publication: | Book / Working Paper |
Language: | English |
Notes: | Mode of access: World Wide Web System requirements: Adobe [Acrobat] Reader required for PDF files Hardcopy version available to institutional subscribers. |
Other identifiers: | 10.3386/w17125 [DOI] |
Source: | ECONIS - Online Catalogue of the ZBW |
Persistent link: https://www.econbiz.de/10012461533