Physical rehabilitation following medicare prospective payment for skilled nursing facilities

Health Services Research
Walter P Wodchis

Abstract

To examine the effect of the Medicare prospective payment system (PPS) for skilled nursing facilities (SNF) on the delivery of rehabilitation therapy to residents. Resident-level data are based on the Resident Assessment Instrument Minimum Data Set for nursing facilities. All elderly residents admitted to SNFs in Michigan and Ohio in 1998 and 1999 form the study population (n=99,952). A differences-in-differences identification strategy is used to compare rehabilitation therapy for SNF residents before and after a change in Medicare SNF payment. Logistic and linear regression analyses are used to examine the effect of PPS on receipt of physical, occupational, or speech therapy and total therapy time. Data for the present study were extracted from the University of Michigan Assessment Archive Project (UMAAP). One assessment was obtained for each resident admitted to nursing facilities during the study period. The introduction of PPS for all U.S. Medicare residents in July of 1998 was associated with specific targeting of rehabilitation treatment time to the most profitable levels of therapy. The PPS was also associated with increased likelihood of therapy but less rehabilitation therapy time for Medicare residents. The present r...Continue Reading

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Citations

Oct 4, 2006·International Journal of Health Care Finance and Economics·R Tamara KonetzkaSally C Stearns
Mar 25, 2008·Health Care Management Review·Jacqueline ZinnDavid Grabowski
Feb 5, 2009·American Journal of Physical Medicine & Rehabilitation·Long NgoLisa I Iezzoni
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Feb 22, 2012·Medicare & Medicaid Research Review·Chapin White, Nguyen Nguyen
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May 5, 2012·Archives of Physical Medicine and Rehabilitation·Wen DombrowskiChaim Y Tarshish
Jun 28, 2011·Journal of Health Economics·David C GrabowskiThomas G McGuire
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Sep 28, 2021·Journal of the American Geriatrics Society·Rachel Prusynski

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