• Media type: E-Article
  • Title: Strategic Patient Discharge: The Case of Long-Term Care Hospitals
  • Contributor: Eliason, Paul J.; Grieco, Paul L. E.; McDevitt, Ryan C.; Roberts, James W.
  • Published: American Economic Association, 2018
  • Published in: American Economic Review, 108 (2018) 11, Seite 3232-3265
  • Language: English
  • DOI: 10.1257/aer.20170092
  • ISSN: 0002-8282
  • Origination:
  • Footnote:
  • Description: <jats:p> Medicare’s prospective payment system for long-term acute-care hospitals (LTCHs) provides modest reimbursements at the beginning of a patient’s stay before jumping discontinuously to a large lump-sum payment after a prespecified number of days. We show that LTCHs respond to the financial incentives of this system by disproportionately discharging patients after they cross the large-payment threshold. We find this occurs more often at for-profit facilities, facilities acquired by leading LTCH chains, and facilities colocated with other hospitals. Using a dynamic structural model, we evaluate counterfactual payment policies that would provide substantial savings for Medicare. (JEL H51, I11, I13, I18) </jats:p>