dc.contributor.author |
McKnight, Robin |
|
dc.date.accessioned |
2004-10-24T14:54:24Z |
|
dc.date.available |
2004-10-24T14:54:24Z |
|
dc.date.issued |
2004-03 |
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dc.identifier.uri |
http://hdl.handle.net/1794/239 |
|
dc.description |
52 p. |
en |
dc.description.abstract |
Long-term care currently comprises almost 10% of national health expenditures and is projected to rise rapidly over coming decades. A key, and relatively poorly understood, element of long-term care is home health care. I use a substantial change in Medicare reimbursement policy, which took the form of tightly binding average per-patient reimbursement caps, to address several questions about the market for home care. I find that the reimbursement change was associated with a large drop in the provision of home care. This drop was concentrated among unhealthy beneficiaries, which is consistent with the incentives for patient selection inherent in the per-patient caps. I find that the decline in home health utilization was not offset by increases in institutional long-term care or other medical care and that there were no associated adverse health consequences. However, approximately one-quarter of the decline in Medicare spending was offset by increases in out-of-pocket expenditures for home health care, with the offset concentrated in higher income populations. Despite the value of home health care implied by the out-of-pocket expenditures, I find that the welfare implications of the reimbursement change were ambiguous. |
en |
dc.description.sponsorship |
National Institute on Aging, Grant
#K12-AG00983 to the National Bureau of Economic Research |
en |
dc.format.extent |
175703 bytes |
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dc.format.mimetype |
application/pdf |
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dc.language.iso |
en_US |
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dc.publisher |
University of Oregon, Dept. of Economics |
en |
dc.relation.ispartofseries |
University of Oregon Economics Department Working Papers;2004-6 |
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dc.subject |
Home heath care |
en |
dc.subject |
Long-term care |
en |
dc.subject |
National health expenditures |
en |
dc.subject |
Medicare reimbursement policy |
en |
dc.title |
Home Care Reimbursement, Long-term Care Utilization, And Health Outcomes |
en |
dc.type |
Working Paper |
en |