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Medicare-covered skilled nursing facility services, 1967-88.

H A Silverman1

  • 1Health Care Financing Administration, Baltimore, MD 21207.

Health Care Financing Review
|January 4, 1992
PubMed
Summary
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Medicare skilled nursing facility benefit administration improved after legislative actions clarified intent. Post-clarification data show increased utilization and program spending, suggesting greater access to skilled nursing facility services.

Area of Science:

  • Health Policy
  • Healthcare Administration
  • Medicare Policy

Background:

  • The Medicare skilled nursing facility (SNF) benefit has faced administrative challenges due to misinterpretation of its intended purpose.
  • Previous administrative and legislative actions aimed to realign the SNF benefit's utilization with its core intent.

Purpose of the Study:

  • To describe legislative and administrative actions taken to clarify the intent of the Medicare skilled nursing facility benefit.
  • To analyze the impact of these actions on SNF utilization and Medicare program expenditures.

Main Methods:

  • Review of legislative and administrative actions related to the Medicare SNF benefit.
  • Analysis of utilization and program expenditure data before and after key policy clarifications.

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Main Results:

  • Legislative and administrative actions were implemented to address misinterpretations of the SNF benefit's intent.
  • Data indicate changes in SNF utilization and program expenditures following these interventions.
  • The 1988 clarifications to level-of-care requirements appear correlated with increased SNF service use.

Conclusions:

  • Policy clarifications have influenced the administration and utilization of the Medicare skilled nursing facility benefit.
  • The 1988 changes likely contributed to an increased demand for skilled nursing facility services under Medicare.