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Medientyp:
E-Artikel
Titel:
Strategic Patient Discharge: The Case of Long-Term Care Hospitals
Beteiligte:
Eliason, Paul J.;
Grieco, Paul L. E.;
McDevitt, Ryan C.;
Roberts, James W.
Erschienen:
American Economic Association, 2018
Erschienen in:
American Economic Review, 108 (2018) 11, Seite 3232-3265
Sprache:
Englisch
DOI:
10.1257/aer.20170092
ISSN:
0002-8282
Entstehung:
Anmerkungen:
Beschreibung:
<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>