PMID: 3320596May 1, 1987Paper

RUGs and equity of access to nursing home care

Medical Care
J A NymanJ E Rohrer

Abstract

Case-adjusted prospective reimbursement systems, such as resource utilization groups (RUGs), may promote nursing home cost containment, but they may do no better than existing systems at encouraging homes to admit the more dependent and thus costlier Medicaid patients, if the homes' reluctance to admit these patients is due to a shortage of nursing home beds. Using 1983 data on Wisconsin nursing homes, this paper presents evidence that suggests that the presence of excess demand, rather than low reimbursement rates, causes nursing homes to exclude the more costly Medicaid patients. Consequently, to benefit fully from RUGs, it is necessary either to eliminate excess demand (by increasing supply or decreasing demand) or to decide which patients have priority for admission and assign reimbursement payments to these patients that significantly favor these patients. Otherwise, access to nursing home care under RUGs is left to chance.(ABSTRACT TRUNCATED AT 250 WORDS)

Citations

Nov 5, 1988·Journal of Health Economics·J A Nyman
Aug 29, 2003·Journal of Health & Social Policy·James H Swan, Ruth B Pickard
Dec 14, 2002·Inquiry : a Journal of Medical Care Organization, Provision and Financing·David C Grabowski
Feb 1, 1989·Journal of the American Geriatrics Society·D Rudman, A G Feller
Jul 28, 2001·Multiple Sclerosis : Clinical and Laboratory Research·R J BuchananD Graber
Aug 16, 2011·Health Services Management Research : an Official Journal of the Association of University Programs in Health Administration·Martha M Perryman, Patrick A Rivers
Feb 3, 1992·Medical Care Review·M A Davis
Sep 12, 2000·Medical Care Research and Review : MCRR·J H SwanS K deWit

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