Home care reimbursement,long-term care utilization,and health outcomes |
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Affiliation: | 1. Toulouse School of Economics, 31015 Toulouse, France;2. LMU, 80539 Munich, Germany |
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Abstract: | Using a substantial change in Medicare reimbursement policy to study the market for home health care, I find that the introduction of tightly binding average per-patient reimbursement caps led to a large drop in the provision of home care, particularly to the least healthy beneficiaries. This decline in home health utilization was not offset by increases in institutional long-term care or other medical care and there were no associated adverse health consequences. However, approximately one-quarter of the decline in Medicare spending was offset by increases in out-of-pocket expenditures for home health care, with the offset concentrated in higher income populations. |
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