000			02226nam a22001577a 4500
999			_c527492 _d527492
008			240902b ||||| |||| 00| 0 eng d
100			_aHackmann, M.B., Pohl, R.V. and Ziebarth, N.R. _957714
245			_aPatient versus provider incentives in long-term care
260			_aAmerican Economic Journal: Applied Economics
300			_a16(3), Jul, 2024: p. 178-218
520			_aThis 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
650			_aLong-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 _957715
773			_aAmerican Economic Journal: Applied Economics
906			_aHEALTH SERVICES
942			_cAR