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Related Experiment Videos

Medicaid nursing facility reimbursement methods: 1979-1997.

J H Swan1, C Harrington, W Clemeña

  • 1Wichita State University, USA.

Medical Care Research and Review : MCRR
|September 12, 2000
PubMed
Summary
This summary is machine-generated.

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State Medicaid nursing facility reimbursement methods evolved significantly from 1979-1997, with shifts towards prospective and casemix approaches. Despite changes, national Medicaid reimbursement policies and rates remain diverse.

Area of Science:

  • Health Services Research
  • Health Economics
  • Public Health Policy

Background:

  • State Medicaid programs are crucial for funding nursing facility care.
  • Reimbursement methods significantly influence provider behavior and service availability.
  • Understanding historical trends in Medicaid reimbursement is vital for current policy analysis.

Purpose of the Study:

  • To describe state Medicaid nursing facility reimbursement methods and rates from 1979 to 1997.
  • To analyze the evolution of reimbursement methodologies over time.
  • To assess the trends in Medicaid per diem rates relative to inflation and general health costs.

Main Methods:

  • Data collection via telephone surveys of state Medicaid reimbursement.
  • Analysis of reimbursement methodologies, including prospective and casemix approaches.

Related Experiment Videos

  • Comparison of Medicaid per diem rate increases with inflation and general health costs.

    • Main Results:

    • The 1980s saw a shift towards prospective reimbursement methodologies.
    • Casemix methods were adopted in the late 1980s and early 1990s.
    • Medicaid per diem rates increased faster than inflation but slower than overall health costs.
    • Despite trends, national Medicaid reimbursement policies and rates exhibit significant diversity.

    Conclusions:

    • State Medicaid nursing facility reimbursement has undergone substantial methodological changes.
    • The repeal of the Boren Amendment presents opportunities for state cost controls.
    • Significant national variation in Medicaid reimbursement policies and rates persists.