title: Impact of the Medicare Catastrophic Coverage Act on nursing homes.
abstract: The Medicare Catastrophic Coverage Act (MCCA) of 1988 altered eligibility and coverage for skilled nursing facility (SNF) care and changed Medicaid eligibility rules for nursing-home residents. Detailed data on the residents of a for-profit nursing-home chain and Medicare claims for a 1 percent sample of beneficiaries were used to examine the impact of the MCCA on nursing homes. The case mix of nursing-home admissions was scrutinized, specifically for length of stay, discharge disposition, rate of hospitalization, and changes in payer source. Findings revealed that, although the proportion of Medicare-financed nursing-home care increased, as did the case-mix severity of residents during the MCCA period, there was no corollary reduction in hospital use by nursing-home residents.
authors.affiliation: Brown University Center for Gerontology and Health Care Research, Providence, RI 02912, USA.
authors.forename: L
authors.initials: L
authors.lastname: Laliberte
authors.forename: V
authors.initials: V
authors.lastname: Mor
authors.forename: K
authors.initials: K
authors.lastname: Berg
authors.forename: O
authors.initials: O
authors.lastname: Intrator
authors.forename: K
authors.initials: K
authors.lastname: Calore
authors.forename: J
authors.initials: J
authors.lastname: Hiris
mesh_terms: D003953:Diagnosis-Related Groups; D004608:Eligibility Determination / Q000331:legislation & jurisprudence*; D005500:Follow-Up Studies; D006302:Health Services Research; D006760:Hospitalization; D006801:Humans; D007354:Insurance, Major Medical / Q000331:legislation & jurisprudence*; D007902:Length of Stay; D008390:Markov Chains; D006278:Medicare / Q000331:legislation & jurisprudence*; D009735:Nursing Homes / Q000331:legislation & jurisprudence*; D010351:Patient Discharge; D014481:United States