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
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)
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/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.
Working Paper: Strategic Patient Discharge: The Case of Long-Term Care Hospitals (2016)
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
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
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 ().