Publications

print share
Version HistoryVersion History

Title

Medicare Payment Policy Creates Incentives for Long-Term Care Hospitals to Time Discharges for Maximum Reimbursement (Health Affairs)

Publication Topics

Access to Health Care; Medicare; Cost and Utilization Studies

Publication Type

Journal Article

Publication Date

2015-06-09T07:00:00Z

Author 1

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1228&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1228&RootFolder=*">Yan S. Kim</a>

Author 2

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1229&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1229&RootFolder=*">Eric C. Kleerup</a>

Author 3

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1230&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1230&RootFolder=*">Patricia A. Ganz</a>

Author 4

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=243&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=243&RootFolder=*">Ninez A. Ponce, PhD, MPP</a>

Author 5

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1231&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=1231&RootFolder=*">Karl A. Lorenz</a>

Author 6

<a onclick="OpenPopUpPage('http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=627&RootFolder=*', RefreshPage); return false;" href="http://healthpolicy.ucla.edu/_layouts/listform.aspx?PageType=4&ListId={7AAD61FA-4BCB-48C0-B0B7-87AFDC3673EF}&ID=627&RootFolder=*">Jack Needleman, PhD</a>

Author 7

Author 8

Author 9

Author 10

Author 11

Author 12

Author 13

Author 14

Abstract

​Long-term care hospitals are post-acute care facilities for patients requiring extended hospital-level care. These facilities are reimbursed by Medicare under a prospective payment system with a short-stay outlier policy, which results in substantially lower payments for patients discharged before a diagnosis-related group–specific short-stay threshold. Using Medicare data, the authors examined the impact of the short-stay policy on lengths-of-stay and Medicare reimbursement among patients in long-term care hospitals who require prolonged mechanical ventilation. After accounting for case-mix and facility-level differences, authors found that discharges for reasons other than death in the period 2005–2010 were most likely to occur on the day of or immediately after the short-stay threshold; this held true regardless of facility ownership. In contrast, live discharges in 2002 — the year before the prospective payment system started phasing out cost-based payment — were evenly distributed around the day that later became the short-stay threshold. Authors' findings confirm that the short-stay outlier payment policy created a strong financial incentive for long-term care hospitals to time patient discharges to maximize Medicare reimbursement. The results suggest that the new very-short-stay policy implemented in December 2012 could have a similar effect.

Thumbnail

Article 1

Journal Article: Medicare Payment Policy Creates Incentives for Long-Term Care Hospitals to Time Discharges for Maximum Reimbursement

Article 2

Article 3

Article 4

Article 5

Article 6

Article 7

Article 8

Article 9

Article 10

Article 11

Article 12

Press Release

Related Link 1

Related Link 2

Related Link 3

Related Link 4

Related Link 5

Related Link 6

Related Link 7

Related Link 8

Related Link 9

Related Link 10

Related Link 11

Related Link 12

Related Link 13

Related Link 14

Related Link 15

Related Link 16

Version: 2.0
Created at 6/9/2015 9:48 AM by i:0#.f|uclachissqlmembershipprovider|celeste
Last modified at 6/9/2015 9:50 AM by i:0#.f|uclachissqlmembershipprovider|celeste