Unbiased Analysis of Today's Healthcare Issues

International Strategies for Skilled Nursing Facility Reimbursement

In the past, I have written about how Medicare pays for Skilled Nursing Facilities (SNF).  Medicare uses a case-mix adjusted per diem rate.  This approach, however, isn’t the only manner payers can use to reimburse nursing facilities.  Consider how Australia pays for nursing care under their Australian National Sub-Acute and Non-Acute Patient Classification System (AN-SNAP): […]

Read the rest of this entry »

Medicare pays $5.1 billion for Poor Quality Skilled Nursing Facility Care

The Office of the Inspector General found substandard care at a number of skilled nursing facilities. Their investigation found the following: For 37 percent of stays, SNFs did not develop care plans that met requirements or did not provide services in accordance with care plans. For 31 percent of stays, SNFs did not meet discharge […]

Read the rest of this entry »

Free-Market Healthcare? Nursing Home Payment and Financing

Although many people believe that the U.S. healthcare system is a free-market, that is far from the case.  Consider nursing homes.  Two-thirds of patient spending on nursing home care comes from public sources.   Not only do public funds pay for the variable cost of running nursing homes, but the federal government also provides low-interest […]

Read the rest of this entry »

Medicare spending for beneficiaries receiving long-term care

Medicare spends a lot of money on beneficiaries living in nursing homes.  How expensive are these beneficiaries: Six percent of Medicare beneficiaries spend some time in a long-term care facility, but these same beneficiaries make up 17% of total Medicare cost. Three percent of Medicare beneficiaries spent an entire year in a long-term care facilities. […]

Read the rest of this entry »

How Medicare payment policy affects SNF incentives to hospitalize patients

Under Medicare Part A, beneficiaries can receive coverage for care provided by skilled nursing facilities (SNFs), also known as nursing homes.  Between 2000 and 2007, however, the rate of potentially avoidable re-hospitalizations for five key conditions (congestive heart failure, respiratory infection, urinary tract infection, sepsis, and electrolyte imbalance) increased from 13.7% to 18.5%. One potential explanation […]

Read the rest of this entry »