Effect of Medicaid payment on rehabilitation care for nursing home residents.
There is considerable interest in examining how Medicaid payment affects nursing home care. This study examines the effect of Medicaid payment methods and reimbursement rates on the delivery of rehabilitation therapy to Medicaid nursing home residents in six States from 1992-1995. In States that changed payment from prospective facility-specific to prospective case-mix adjusted payment methods, Medicaid residents received more rehabilitation therapy after the change. While residents in States using case-mix adjusted payment rates for Medicaid payment were more likely to receive rehabilitation than residents in States using prospective facility-specific Medicaid payment, the differences were general and not specific to Medicaid residents. Retrospective payment for Medicaid resident care was associated with greater use of therapy for Medicaid residents.
Wodchis
Walter P
WP
Department of Health Policy, Management and Evaluation, University of Toronto, Ontario. walter.wodchis@utoronto.ca
Hirth
Richard A
RA
Fries
Brant E
BE
D000368:Aged; D003953:Diagnosis-Related Groups; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D008484:Medicaid / Q000458:organization & administration*; D009735:Nursing Homes / Q000191:economics*; D011907:Rate Setting and Review; D012046:Rehabilitation / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms; D014481:United States