| Publications [#325455] of James W. Roberts
Journal Articles
- Eliason, PJ; Grieco, PLE; McDevitt, RC; Roberts, JW, Strategic Patient Discharge: the Case of Long-Term Care Hospitals.
(November, 2018),
pp. 3232-3265 [doi]
(last updated on 2023/06/01)
Abstract: 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.
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