title: Hospital-based and freestanding skilled nursing facilities: any cause for differential Medicare payments?
abstract: Differential Medicare payments for hospital-based and freestanding skilled nursing facilities (SNFs) were eliminated by the SNF prospective payment system initiated in 1998. Closures and high negative margins of hospital-based facilities have prompted consideration of the need to revisit payment adjustments for this group of SNFs. We examine case mix-related and other factors behind the cost differences between hospital-based and freestanding SNFs. Some payment adjustment, notably for nontherapy ancillary services, may be reasonable for the short term.
authors.affiliation: Urban Institute, Washington, DC 20037, USA.
authors.forename: Korbin
authors.initials: K
authors.lastname: Liu
authors.forename: Kirsten J
authors.initials: KJ
authors.lastname: Black
mesh_terms: D003953:Diagnosis-Related Groups / Q000191:economics*; D006233:Persons with Disabilities; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006271:Health Facility Closure; D006302:Health Services Research; D006754:Hospital Restructuring; D006801:Humans; D007182:Income; D006278:Medicare / Q000331:legislation & jurisprudence*; D010067:Ownership; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D011445:Prospective Payment System / Q000331:legislation & jurisprudence*; D012046:Rehabilitation / Q000191:economics / Q000706:statistics & numerical data; D012866:Skilled Nursing Facilities / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D019467:Subacute Care / Q000145:classification* / Q000191:economics; D014481:United States; D014600:Utilization Review