Article Abstract:
The effect of integrated community nursing services on hospital use and costs for the aged in a health maintenance organization (HMO) is estimated. A total of 4,943 HMO patients were tracked for three consecutive five-month periods. Regression analysis indicates that patients who were given integrated services had substantially higher utilization and costs during enrollment and substantially lower utilization and costs following enrollment, in contrast to nonprogram patients. Results prove that integrating services at the community level can significantly cut costs.
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Article Abstract:
The Medicare Catastrophic Coverage Act (MCCA) of 1989 was enacted to broaden post-acute care benefits of Medicare enrollees, cut copayments and raise the standard for Medicaid eligibility. A semi-Markov transition model is used to measure the impact of MCCA on Medicare coverage and the spend-down rate of 5,551 new nursing home admissions. Findings show that Medicare use rose in 1989 and the risk of shifting from Medicare to self-pay was lower than 1988. There was a 60% probability that spend-down from self-pay to Medicaid would likely to happen in 1990.
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Article Abstract:
Medicare spending tends to be higher for elderly people expriencing functional limitation than other beneficiaries. The degree of spending, however, varies with elderly people living in community residents having higher Medicare spending than those living in nursing home residents. Such differences exist due to higher utilization of inpatient hospital and home health care by elderly people living in community residents.
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