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Medicare-covered skilled nursing facility services, 1967-88.
1Health Care Financing Administration, Baltimore, MD 21207.
Health Care Financing Review
|January 4, 1992
Summary
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.
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.