Effects of Medicare payment reform: Evidence from the home health interim and prospective payment systems

Peter J. Huckfeldt, Neeraj Sood, José J. Escarce, David C. Grabowski, Joseph P. Newhouse

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Medicare continues to implement payment reforms that shift reimbursement from fee-for-service toward episode-based payment, affecting average and marginal payment. We contrast the effects of two reforms for home health agencies. The home health interim payment system in 1997 lowered both types of payment; our conceptual model predicts a decline in the likelihood of use and costs, both of which we find. The home health prospective payment system in 2000 raised average but lowered marginal payment with theoretically ambiguous effects; we find a modest increase in use and costs. We find little substantive effect of either policy on readmissions or mortality.

Original languageEnglish (US)
Pages (from-to)1-18
Number of pages18
JournalJournal of Health Economics
Volume34
Issue number1
DOIs
StatePublished - Mar 2014

Keywords

  • Medicare
  • Prospective payment
  • Selection
  • Treatment intensity

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