The Medicare Hospice Payment System: A Consideration of Potential Refinements
Year: 2006
Type: preprint
Study design: Observational Study
Abstract: This paper evaluates the appropriateness of Medicare's per diem payment system for hospice in light of recent changes in the hospice patient population and provision of care. We rely on proprietary data from a large chain provider which allows us to examine utilization measures based on the number of visits and the labor costs associated with the provision of care. Due to detailed data on individual visits, we can examine how utilization varies across patients as well as within each patient's stay. Our findings suggest that the current hospice payment system accurately reflects resource use across patients and that available case mix adjusters would not improve the system's performance. However, we do find that there is substantial variation in patient-level costs within stays that is not captured in the current per diem payment system. These findings suggest that the per diem system could be adjusted to more accurately capture variation in costs within stays by compensating hospices more generously for the beginnings and ends of stays.
Source: SSRN Electronic Journal
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W3165134980