scholarly journals The Impact of the Prospective Payment System for Skilled Nursing Facilities on Therapy Service Provision: A Transaction Cost Approach

2003 ◽  
Vol 38 (6p1) ◽  
pp. 1467-1486 ◽  
Author(s):  
Jacqueline S. Zinn ◽  
Vincent Mor ◽  
Orna Intrator ◽  
Zhanlian Feng ◽  
Joseph Angelelli ◽  
...  
Keyword(s):  
Transaction Cost ◽  
Service Provision ◽  
Prospective Payment System ◽  
Payment System ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Prospective Payment ◽  
Skilled Nursing ◽  
The Impact ◽  
Therapy Service

scholarly journals Medicare's Prospective Payment System for Skilled Nursing Facilities: Effects on Staffing and Quality of Care

2005 ◽  
Vol 42 (4) ◽  
pp. 351-366 ◽  
Author(s):  
Chapin White
Keyword(s):  
Quality Of Care ◽  
Nurse Staffing ◽  
Prospective Payment System ◽  
Payment System ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Prospective Payment ◽  
Skilled Nursing ◽  
Facility Level

In 1998, Medicare began phasing in a new prospective payment system (PPS) for skilled nursing facilities (SNFs). This paper measures facility-level changes in nurse staffing and quality at freestanding SNFs from 1997 (pre-PPS) to 2001 (post-PPS). Findings show a positive but small association between changes in payment levels and changes in nurse staffing. Among for-profits, the elimination of cost reimbursement is associated with a large drop in nurse staffing. Additionally, the elimination of cost reimbursement is associated with worsening in one of four measures of quality of care; however, the quality results are not statistically robust.

Hospital-Based and Freestanding Skilled Nursing Facilities: Any Cause for Differential Medicare Payments?

2003 ◽  
Vol 40 (1) ◽  
pp. 94-104 ◽  
Author(s):  
Korbin Liu ◽  
Kirsten J. Black
Keyword(s):  
Prospective Payment System ◽  
Ancillary Services ◽  
Skilled Nursing Facilities ◽  
Case Mix ◽  
Nursing Facilities ◽  
Prospective Payment ◽  
Short Term ◽  
Skilled Nursing ◽  
The Cost ◽  
Cost Differences

Differential Medicare payments for hospital-based and freestanding skilled nursing facilities (SNFs) were eliminated by the SNF prospective payment system initiated in 1998. Closures and high negative margins of hospital-based facilities have prompted consideration of the need to revisit payment adjustments for this group of SNFs. We examine case mix-related and other factors behind the cost differences between hospital-based and freestanding SNFs. Some payment adjustment, notably for nontherapy ancillary services, may be reasonable for the short term.

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