Explaining state Medicaid nursing home reimbursement.
Medicaid nursing home reimbursement methods and per diem rates affect costs, quality, equity, and access. State rate-setting is a laboratory of policymaking, which can inform state and federal Medicaid reform initiatives. This paper explains state Medicaid nursing facility rates in 1979-1994. Findings suggest that prospective facility-specific methods constrained rates in some but not all periods, particularly when older cost-reports were employed in rate-setting. Analysis failed to show that prospective class rate-setting methods constrained rate increases. Findings suggest that the efficacy of reimbursement methodology to control rates depends upon wider health care policy trends and that future facility-level analyses should consider policy contexts as between states.
Swan
J H
JH
Department of Public Health Sciences, Wichita State University, Wichita, KS 67260-0152, USA.
Harrington
C
C
Pickard
R B
RB
D000368:Aged; D003625:Data Collection; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000191:economics*; D011907:Rate Setting and Review / Q000379:methods* / Q000639:trends; D012044:Regression Analysis; D012051:Reimbursement Mechanisms / Q000639:trends*; D012109:Research Support as Topic; D013221:State Health Plans / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States