Suchergebnisse

Home health agencies (HHAs) are one of the most commonly used third-party providers in the assisted living (AL) setting. One way ALs may be potentially able to meet the needs of their residents despite increased impairment is through supplementing the services offered with those delivered by HHAs. We explore the growth in the delivery of HHA services to Medicare beneficiaries in AL compared with other home settings between 2012 and 2014. We also examine demographic, cognitive, and functional characteristics of beneficiaries; HHA provider characteristics; and the variation in the percentage of home health use in ALs across the country. Our findings suggest that there was a slight growth in the share of HHA services being delivered in AL. HHA recipients in AL were more likely to have cognitive and activities of daily living impairments than those receiving HHA services in other settings. This is among the first studies to examine HHA utilization in AL.

Medicare and Medicaid dual-eligible beneficiaries use more medical care and experience worse health outcomes than Medicare-only beneficiaries. This article points to a possible inefficiency in the skilled nursing facility (SNF) admission process, specifically that patients and SNFs are partially matched based on dual-eligibility status, and investigates its influence on patients' SNF length of stay. Using a set of fee-for-service beneficiaries newly admitted for Medicare-paid SNF care, we document two findings: (1) compared with Medicare-only patients, dual-eligibles are more likely to be discharged to SNFs with low nurse-to-patient ratios and (2) dual-eligibles are more likely to become long-stay nursing home residents than Medicare-only beneficiaries if treated in SNFs with low nurse-to-patient ratios. We conclude that changes in the current SNF care referral process have the potential to reduce excess SNF utilization by dual-eligible beneficiaries and could help reduce spending by both Medicare and Medicaid.