Some observers may say the timing was preordained. Against the backdrop of Tenet Healthcare Corp.'s mounting woes, the Catholic Health Association, headed by the Rev. Michael Place (left), is expected this week to release a report arguing that Roman Catholic hospitals deserve special and distinct financial concessions from the federal government because of the role they play.
Nursing homes represent the fastest growing component of health care expenditures, over half of which come from public funds. This paper reviews research on nursing home utilization with regard to several policy issues concerning the subsidization of long-term care by Medicaid. As a background, the paper defines and contrasts three concepts; need, demand, and utilization.
Health care for the indigent is a major problem in the United States. This review of the literature on health care for the indigent was undertaken to determine which major questions remain unresolved. Overall, this article finds that a very large pool of individuals under age 65 are at risk of being medically indigent.
Several recent studies have shown that physician participation in state Medicaid programs is directly related to the generosity of their reimbursement levels. The implication is that when states reduce fees, Medicaid eligibles suffer because their access to physicians' services is thereby limited. The results presented in this paper do not support this implication.
Although the era of deinstitutionalization of the aged from state mental facilities and of the rapid growth of the nursing home industry appears to have ended, the question remains of the extent to which nursing home care is substituted for psychiatric care. To study this question, the numbers per capita of Medicaid program recipients of inpatient psychiatric care for each state in the period 1979-82 was regressed on numbers per capita of Medicaid nursing home recipients, numbers of nursing home beds per capita, and the percentage aged.
Every year since 1984, Congress has expanded Medicaid to cover an increasing proportion of low-income children. In this study, a multivariate analysis of data from the 1987 National Medical Expenditure Survey was used to determine whether expanded Medicaid eligibility is likely to be effective in encouraging recommended preventive visits for low-income, preschool children.
This study examines the effects of physician fees on children's use of preventive and illness-related ambulatory physician services under the Medicaid program. Using data from the 1987 National Medical Expenditure Survey (NMES), we examine the effects of Medicaid fee generosity on physician service use and overall ambulatory physician spending. The results indicate that more generous fees are associated with a greater likelihood of having a doctor's office as a usual source of care and a higher number of preventive visits at office-based sites of care.
This study investigates the capacity of hospitals to vary the intensity of their services based on patients' expected sources of payment. While the concept of price discrimination by hospitals based on payer generosity ("cost-shifting") has been discussed extensively, the notion that hospitals can adjust payer-specific marginal costs to reflect differences in reimbursement policies has not been studied in depth. To examine this issue.
Recent battle cries to boost health care coverage for children might suggest help is on the way. Yet as politicians tout their new-found generosity, they've also been snatching away some government money for kids.
OBJECTIVES: Both the Medicare and Medicaid programs have experienced considerable growth in spending on home care in recent years. As policymakers adopt measures (such as those legislated in the Balanced Budget Act of 1997) to curb the rate of spending growth on home care services, it is important to understand interactions between the Medicare and Medicaid home care programs in serving the dually enrolled population. This study examines the potential effects of the Medicaid home care program on Medicare home health utilization using multivariate models.