EconPapers    
Economics at your fingertips  
 

Strategic Patient Discharge: The Case of Long-Term Care Hospitals

Paul J. Eliason, Paul L. E. Grieco, Ryan McDevitt and James W. Roberts

American Economic Review, 2018, vol. 108, issue 11, 3232-65

Abstract: Medicare's prospective payment system for long-term acute-care hospitals (LTCHs) provides modest reimbursements at the beginning of a patient's stay before jumping discontinuously to a large lump-sum payment after a prespecified number of days. We show that LTCHs respond to the financial incentives of this system by disproportionately discharging patients after they cross the large-payment threshold. We find this occurs more often at for-profit facilities, facilities acquired by leading LTCH chains, and facilities colocated with other hospitals. Using a dynamic structural model, we evaluate counterfactual payment policies that would provide substantial savings for Medicare.

JEL-codes: H51 I11 I13 I18 (search for similar items in EconPapers)
Date: 2018
Note: DOI: 10.1257/aer.20170092
References: Add references at CitEc
Citations: View citations in EconPapers (1) Track citations by RSS feed

Downloads: (external link)
https://www.aeaweb.org/doi/10.1257/aer.20170092 (application/pdf)
https://www.aeaweb.org/articles/attachments?retrie ... ySv3aMa_bx1at08cxvPj (application/zip)
https://www.aeaweb.org/articles/attachments?retrie ... JNwhCeivzb7WXdRS0tWO (application/pdf)
https://www.aeaweb.org/articles/attachments?retrie ... tN98ViqPvTL6_4i12BwR (application/zip)
Access to full text is restricted to AEA members and institutional subscribers.

Related works:
Working Paper: Strategic Patient Discharge: The Case of Long-Term Care Hospitals (2016) Downloads
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:aea:aecrev:v:108:y:2018:i:11:p:3232-65

Ordering information: This journal article can be ordered from
https://www.aeaweb.org/journals/subscriptions

Access Statistics for this article

American Economic Review is currently edited by Esther Duflo

More articles in American Economic Review from American Economic Association Contact information at EDIRC.
Bibliographic data for series maintained by Michael P. Albert ().

 
Page updated 2019-02-09
Handle: RePEc:aea:aecrev:v:108:y:2018:i:11:p:3232-65