title: Staffing subsidies and the quality of care in nursing homes.
abstract: Concerns about the quality of state-financed nursing home care has led to the wide-scale adoption by states of pass-through subsidies, in which Medicaid reimbursement rates are directly tied to staffing expenditure. We examine the effects of Medicaid pass-through on nursing home staffing and quality of care by adapting a two-step FGLS method that addresses clustering and state-level temporal autocorrelation. We find that pass-through subsidies increases staffing by about 1% on average and 2.7% in nursing homes with a low share of Medicaid patients. Furthermore, pass-through subsidies reduce the incidences of pressure ulcer worsening by about 0.9%.
authors: Department of Economics, Brown University, Providence, RI 02912, USA. Electronic address: afoster@brown.edu.
authors: Andrew D
authors: AD
authors: Foster
authors: Freeman Spogli Institute of International Studies, Stanford University, Stanford CA 94305, USA. Electronic address: yongslee@stanford.edu.
authors: Yong Suk
authors: YS
authors: Lee
mesh_terms: D036262:Empirical Research; D006801:Humans; D008484:Medicaid / Q000191:economics; D015233:Models, Statistical; D009735:Nursing Homes; D009740:Nursing Staff / Q000458:organization & administration*; D016134:Organizational Policy; D010561:Personnel Staffing and Scheduling / Q000191:economics*; D011787:Quality of Health Care; D012052:Reimbursement, Incentive / Q000191:economics; D014481:United States
keywords: FGLS; Medicaid; Nursing home; Quality of care; Wage pass-through