Abstract：
:In 1998, Medicare adopted a per diem Prospective Payment System (PPS) for skilled nursing facility care, which was intended to deter the use of high-cost rehabilitative services. The average per diem decreased under the PPS, but because per diems increased for greater therapy minutes, the ability of the PPS to deter the use of high-intensity services was questionable. In this study, we assess how the PPS affected the volume and intensity of Medicare services. By volume we mean the product of the number of Medicare residents in a facility and the average length-of-stay, by intensity we mean the time per week devoted to rehabilitation therapy. Our results indicate that the number of Medicare residents decreased under PPS, but rehabilitative services and therapy minutes increased while length-of-stay remained relatively constant. Not surprisingly, when subsequent Medicare policy changes increased payment rates, Medicare volume far surpassed the levels seen in the pre-PPS period.
journal_name
J Health Econjournal_title
Journal of health economicsauthors
Grabowski DC,Afendulis CC,McGuire TGdoi
10.1016/j.jhealeco.2011.05.014subject
Has Abstractpub_date
2011-07-01 00:00:00pages
675-84issue
4eissn
0167-6296issn
1879-1646pii
S0167-6296(11)00067-1journal_volume
30pub_type
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