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Strategic Patient Discharge: The Case of Long-Term Care Hospitals / Paul J. Eliason, Paul L. E. Grieco, Ryan C. McDevitt, James W. Roberts.
- Format:
- Book
- Author/Creator:
- Eliason, Paul J.
- Series:
- Working Paper Series (National Bureau of Economic Research) no. w22598.
- NBER working paper series no. w22598
- Language:
- English
- Physical Description:
- 1 online resource: illustrations (black and white);
- Other Title:
- Strategic Patient Discharge
- Place of Publication:
- Cambridge, Mass. National Bureau of Economic Research 2016.
- Summary:
- Medicare's prospective payment system for long-term acute-care hospitals (LTCHs) pro- vides modest reimbursements at the beginning of a patient's stay before jumping discontinuously to a large lump-sum payment after a pre-specified number of days. We show that LTCHs respond to financial incentives by disproportionately discharging patients after they cross the large-payment threshold, resulting in worse outcomes for patients. We find this occurs more often at for-profit facilities, facilities acquired by leading LTCH chains, and facilities co-located with other hospitals. Using a dynamic structural model, we evaluate counterfactual payment policies that would provide substantial savings for Medicare without adversely affecting patients.
- Notes:
- Print version record
- September 2016.
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