Patient versus provider incentives in long-term care
By: Hackmann, M.B., Pohl, R.V. and Ziebarth, N.R
.
Material type: 
BookPublisher: American Economic Journal: Applied Economics Description: 16(3), Jul, 2024: p. 178-218.Subject(s): Long-Term Care, Patient Incentives, Provider Incentives, Medicaid, Nursing Home Stays, Cost Sharing, Facility Capacity, Private Payers, Financial Elasticity, Episode-Based Reimbursement, Community-Based Care, Payment Models
In:
American Economic Journal: Applied EconomicsSummary: This study analyzes 551,000 nursing home stays to examine how patient and provider incentives shape long-term care provision. It finds that Medicaid-covered residents tend to extend their stays due to limited cost-sharing, while nursing homes shorten these stays when capacity constraints arise to accommodate more profitable private payers. Providers demonstrate greater responsiveness to financial incentives than patients. Consequently, reforms targeting provider behavior—such as episode-based reimbursement—are more effective than increasing patient cost-sharing in promoting transitions to community-based care and achieving long-term care savings. :How do patient and provider incentives affect the provision of long-term care? Our analysis of 551,000 nursing home stays yields three main insights. First, due to limited cost-sharing, Medicaid-covered residents prolong their nursing home stays instead of transitioning to community-based care. Second, when facility capacity binds, nursing homes shorten Medicaid stays to admit more profitable out-of-pocket private payers. Third, providers react more elastically to financial incentives than patients. Thus, targeting provider incentives through alternative payment models, such as episode-based reimbursement, is more effective than increasing patient cost sharing in facilitating transitions to community-based care and generating long-term care savings.- Reproduced
https://www.aeaweb.org/articles?id=10.1257/app.20210264
| Item type | Current location | Call number | Vol info | Status | Date due | Barcode |
|---|---|---|---|---|---|---|
Articles
|
Indian Institute of Public Administration | 16(3), Jul, 2024: p. 178-218 | Available | AR132933 |
This study analyzes 551,000 nursing home stays to examine how patient and provider incentives shape long-term care provision. It finds that Medicaid-covered residents tend to extend their stays due to limited cost-sharing, while nursing homes shorten these stays when capacity constraints arise to accommodate more profitable private payers. Providers demonstrate greater responsiveness to financial incentives than patients. Consequently, reforms targeting provider behavior—such as episode-based reimbursement—are more effective than increasing patient cost-sharing in promoting transitions to community-based care and achieving long-term care savings. :How do patient and provider incentives affect the provision of long-term care? Our analysis of 551,000 nursing home stays yields three main insights. First, due to limited cost-sharing, Medicaid-covered residents prolong their nursing home stays instead of transitioning to community-based care. Second, when facility capacity binds, nursing homes shorten Medicaid stays to admit more profitable out-of-pocket private payers. Third, providers react more elastically to financial incentives than patients. Thus, targeting provider incentives through alternative payment models, such as episode-based reimbursement, is more effective than increasing patient cost sharing in facilitating transitions to community-based care and generating long-term care savings.- Reproduced
https://www.aeaweb.org/articles?id=10.1257/app.20210264
There are no comments for this item.