Impact of the BBA on post-acute utilization

Area of Science:

• Health Policy
• Healthcare Economics
• Gerontology

Background:

• Medicare's post-acute care (PAC) landscape has undergone significant payment policy revisions.
• The Balanced Budget Act of 1997 (BBA) introduced new financial incentives and restrictions impacting PAC providers.
• Understanding pre-BBA service patterns is crucial for evaluating current policy effects.

Purpose of the Study:

• To summarize recent Medicare post-acute payment policy changes.
• To analyze patient utilization patterns across skilled nursing facilities (SNFs), home health agencies (HHAs), and rehabilitation units.
• To assess the impact of new payment policies on site-of-care decisions.

Main Methods:

• Review of Medicare post-acute payment policies.
• Analysis of patient demographics and service utilization across different PAC providers.
• Comparative analysis of pre- and post-BBA payment systems.

Main Results:

• Identified differences in patient populations treated by SNFs, HHAs, and rehabilitation units.
• Examined the implications of design and implementation issues within new PAC payment policies.
• Assessed how financial incentives in restrictive payment policies may affect service patterns.

Conclusions:

• New Medicare payment policies may influence patient care site selection.
• Potential for shifts in service patterns due to financial incentives in PAC.
• Further analysis needed on the long-term effects of payment reforms on PAC delivery.