Biomaterial Database

Medicaid payment rates for nursing homes, 1979-86. 1990

S F Gohmann, and R L Ohsfeldt

Department of Economics, University of Louisville, Kentucky 40292.

The issue of the cost containment effects of payment systems on per diem payments by Medicaid to nursing homes is addressed. Estimates of real payment rates as a function of broadly defined payment system classifications and economic and demographic variables using State-level data are presented. Little support for the notion that prospective payment systems substantially restrain payment rates for intermediate care facilities is found, but some model specifications indicate possible cost savings associated with prospective payment systems for skilled nursing facilities. Significant methodological concerns that need to be addressed in future research on the cost containment effects of payment systems are also discussed.

UI	MeSH Term	Description	Entries
D007380	Intermediate Care Facilities	Institutions which provide health-related care and services to individuals who do not require the degree of care which hospitals or skilled nursing facilities provide, but because of their physical or mental condition require care and services above the level of room and board.	Care Facilities, Intermediate,Care Facility, Intermediate,Facilities, Intermediate Care,Facility, Intermediate Care,Intermediate Care Facility
D008484	Medicaid	Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.	Dental Medicaid Program,Medical Assistance, Title 19,Dental Medicaid Programs,Medicaid Program, Dental,Medicaid Programs, Dental,Program, Dental Medicaid,Programs, Dental Medicaid
D009735	Nursing Homes	Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization.	Homes, Nursing,Nursing Home
D011445	Prospective Payment System	A system wherein reimbursement rates are set, for a given period of time, prior to the circumstances giving rise to actual reimbursement claims.	Discretionary Adjustment Factor,Prospective Pricing,Prospective Reimbursement,Reimbursement, Prospective,Adjustment, Discretionary,Adjustment Factor, Discretionary,Adjustment Factors, Discretionary,Adjustments, Discretionary,Discretionary Adjustment,Discretionary Adjustment Factors,Discretionary Adjustments,Factor, Discretionary Adjustment,Factors, Discretionary Adjustment,Payment System, Prospective,Payment Systems, Prospective,Pricing, Prospective,Prospective Payment Systems,Prospective Reimbursements,Reimbursements, Prospective,System, Prospective Payment,Systems, Prospective Payment
D011907	Rate Setting and Review	A method of examining and setting levels of payments.	Rate Setting, Review,Review and Rate Setting,Rate Settings, Review,Review Rate Setting,Review Rate Settings,Setting, Review Rate,Settings, Review Rate
D003363	Cost Control	The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed)	Cost Containment,Containment, Cost,Containments, Cost,Control, Cost,Controls, Cost,Cost Containments,Cost Controls
D012866	Skilled Nursing Facilities	Extended care facilities which provide skilled nursing care or rehabilitation services for inpatients on a daily basis.	Extended Care Facilities,Facilities, Skilled Nursing,Nursing Facilities, Skilled,Care Facilities, Extended,Care Facility, Extended,Extended Care Facility,Facilities, Extended Care,Facility, Extended Care,Facility, Skilled Nursing,Nursing Facility, Skilled,Skilled Nursing Facility
D014481	United States	A country in NORTH AMERICA between CANADA and MEXICO.