Do financial incentives of introducing case mix reimbursement increase feeding tube use in nursing home residents?
OBJECTIVE
To determine whether adoption of Medicaid case mix reimbursement is associated with greater prevalence of feeding tube use in nursing home (NH) residents.


METHODS
Secondary analysis of longitudinal administrative data about the prevalence of feeding tube insertion and surveys of states' adoption of case mix reimbursement.


METHODS
NHs in the United States.


METHODS
NH residents at the time of NH inspection between 1993 and 2004.


METHODS
Facility prevalence of feeding tubes reported at the state inspection of NHs reported in the Online Survey, Certification and Reporting database and interviews with state policy makers regarding the adoption of case mix reimbursement.


RESULTS
Between 1993 and 2004, 16 states adopted Resource Utilization Group case mix reimbursement. States varied in the prevalence of feeding tubes in their NHs. Although the use of feeding tube increased substantially over the years of the study, once temporal trends and facility fixed effects were accounted for, case mix reimbursement was not associated with greater prevalence of feeding tube use.


CONCLUSIONS
The adoption of Medicaid case mix reimbursement was not associated with an increase in the prevalence of feeding tube use.
Teno
Joan M
JM
Center for Gerontology and Health Care Research, Department of Community Health, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA. Joan_Teno@brown.edu
Feng
Zhanlian
Z
Mitchell
Susan L
SL
Kuo
Sylvia
S
Intrator
Orna
O
Mor
Vincent
V
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000191:economics / Q000451:nursing*; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups / Q000191:economics*; D004750:Enteral Nutrition / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006707:Homes for the Aged / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008484:Medicaid / Q000191:economics*; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data*; D012052:Reimbursement, Incentive / Q000706:statistics & numerical data*; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data