Effects of state Medicaid home care Medicare maximization programs on Medicare expenditures.
Some state Medicaid programs have attempted to shift home health care costs to Medicare by using retrospective Medicare maximization billing practices. We used a two-part model with random effects to analyze whether retrospective billing practices increase Medicare expenditures for dual eligibles by analyzing primary data collected from 47 state Medicaid offices supplemented with Medicare Current Beneficiary Survey (MCBS) data from 1992-1997. Retrospective billing practices were projected to increase Medicare home health care expenditures by 73.8 million dollars over six years, although this was not statistically significant. We also found significantly higher Medicare spending in states with lower Medicaid spending levels, suggesting that states with high Medicaid utilization have potential to shift some of these expenditures to Medicare.
Anderson
Wayne L
WL
Research Triangle Institute, 3040 Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709-2194, USA.
Norton
Edward C
EC
Kenney
Genevieve S
GS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003361:Cost Allocation / Q000379:methods; D005102:Health Expenditures / Q000706:statistics & numerical data* / Q000639:trends; D006302:Health Services Research; D006299:Health Services for the Aged / Q000191:economics*; D006699:Home Care Services / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008484:Medicaid / Q000458:organization & administration* / Q000706:statistics & numerical data; D006278:Medicare / Q000458:organization & administration* / Q000706:statistics & numerical data; D008875:Middle Aged; D010350:Patient Credit and Collection / Q000379:methods*; D015397:Program Evaluation; D012044:Regression Analysis; D012051:Reimbursement Mechanisms; D013221:State Health Plans / Q000191:economics; D014481:United States