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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 5 of 5 Research Studies DisplayedHe D, McHenry P, Mellor JM
Do financial incentives matter? Effects of Medicare price shocks on skilled nursing facility care.
The authors provided new evidence on how Medicare payment changes affect the amount of skilled nursing facility (SNF) care provided to Medicare patients. They found that increases in Medicare payment rates to SNFs increased the total number of Medicare resident days at SNFs. Further, the effects were asymmetric; although Medicare payment increases affected Medicare days, payment decreases did not. They conclude that their results have important implications for policies that alter the Medicare base payment rates to SNFs and other health care providers.
AHRQ-funded; HS025529.
Citation: He D, McHenry P, Mellor JM .
Do financial incentives matter? Effects of Medicare price shocks on skilled nursing facility care.
Health Econ 2020 Jun;29(6):655-70. doi: 10.1002/hec.4009..
Keywords: Medicare, Nursing Homes, Elderly, Payment, Healthcare Costs
Werner RM, Konetzka RT, Qi M
The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs.
The objective of this study was to investigate the impact of Medicare's skilled nursing facility (SNF) copayment policy, with a large increase in the daily copayment rate on the 20th day of a benefit period, on length of stay, patient outcomes, and costs. The investigators concluded that Medicare's SNF copayment policy was associated with shorter lengths of stay and worse patient outcomes, suggesting the copayment policy had unintended and negative effects on patient outcomes.
AHRQ-funded; HS024266.
Citation: Werner RM, Konetzka RT, Qi M .
The impact of Medicare copayments for skilled nursing facilities on length of stay, outcomes, and costs.
Health Serv Res 2019 Dec;54(6):1184-92. doi: 10.1111/1475-6773.13227..
Keywords: Medicare, Nursing Homes, Payment, Long-Term Care, Healthcare Costs, Elderly, Hospitalization, Hospital Discharge
Chatterjee P, Qi M, Coe NB
Association between high discharge rates of vulnerable patients and skilled nursing facility copayments.
The authors sought to determine whether patterns of skilled nursing facility (SNF) discharge are associated with the change in Medicare payment responsibility on day 20. They found that Medicare beneficiaries were more often discharged from SNFs on benefit day 20 than on benefit days 19 or 21. Those discharged on day 20 were more likely to be racial/ethnic minorities and to live in areas of lower socioeconomic status compared with those discharged before or after day 20. Their findings suggested an association between disproportionately high SNF discharge rates of vulnerable patients and existing Medicare payment policies. The authors recommended that payment policies be designed with consideration of the potential for such unintended consequences, and that any potential consequences be mitigated by balancing existing payment structures with incentives to provide optimal patient care.
AHRQ-funded; HS024266.
Citation: Chatterjee P, Qi M, Coe NB .
Association between high discharge rates of vulnerable patients and skilled nursing facility copayments.
JAMA Intern Med 2019 Sep;179(9):1296-98. doi: 10.1001/jamainternmed.2019.1209.
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Keywords: Vulnerable Populations, Nursing Homes, Medicare, Payment, Policy, Social Determinants of Health
Zhu JM, Navathe A, Yuan Y
Medicare's bundled payment model did not change skilled nursing facility discharge patterns.
The purpose of this study was to evaluate whether participation in Medicare's voluntary Bundled Payments for Care Improvement (BPCI) model was associated with changes in discharge referral patterns to skilled nursing facilities (SNFs), specifically number of SNF partners and discharge concentration. The investigators concluded that hospital participation in BPCI was not associated with changes in the number of SNF partners or in discharge concentration relative to non-BPCI hospitals.
AHRQ-funded; HS024266.
Citation: Zhu JM, Navathe A, Yuan Y .
Medicare's bundled payment model did not change skilled nursing facility discharge patterns.
Am J Manag Care 2019 Jul;25(7):329-34..
Keywords: Medicare, Payment, Practice Patterns, Hospital Discharge, Nursing Homes
Lepore MJ, Shield RR, Looze J
Medicare and Medicaid reimbursement rates for nursing homes motivate select culture change practices but not comprehensive culture change.
The researchers use mixed methods to examine the presence of culture change practices in the context of a nursing home’s (NH’s) payer sources. They concluded that qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher (measured) environmental culture change implementation.
AHRQ-funded; HS000011.
Citation: Lepore MJ, Shield RR, Looze J .
Medicare and Medicaid reimbursement rates for nursing homes motivate select culture change practices but not comprehensive culture change.
J Aging Soc Policy 2015;27(3):215-31. doi: 10.1080/08959420.2015.1022102..
Keywords: Nursing Homes, Medicare, Medicaid, Payment, Health Insurance