Medicaid case-mix nursing home reimbursement in three states
Swan, James H. Pickard, Ruth B.
Swan, James H.
Pickard, Ruth B.
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2003
Type
Article
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Keywords
Comparative Study,Research Support, U.S. Gov't, Non-P.H.S.
Subjects (LCSH)
Citation
Journal of health & social policy. 2003; 16(4): 27-53.
Abstract
Case-mix nursing facility payment raises issues of access, quality, equity, and cost. Case-mix should better match payment to costs, improve access, and provide incentives to increased staffing and quality of care; but it may also increase costs. This paper reports analysis of Medicaid cost-report data from three case-mix states. Case-mix did not discourage capacity building and was more equitable for providers. Medicaid access declined in one state but increased in another. There were shifts toward greater skilled care in two states, with evidence of greater focus of resources on patient care. Case-mix showed no evidence of cost-constraint and some signs of increased costs. Whether such mixed outcomes are viable in the current era remains to be seen.
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Publisher
Routledge
Journal
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Series
Journal of Health & Social Policy
J Health Soc Policy
J Health Soc Policy
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DOI
ISSN
0897-7186