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HomeMedicare Dispatch → Post-acute care: Medicare Advantage vs. traditional Medicare

Post-acute care: Medicare Advantage vs. traditional Medicare Print E-mail
Written by Austin Frakt | The Incidental Economist   
Saturday, 20 May 2017 10:46

From a public spending point of view, post-acute care is particularly problematic. Most of Medicare's geographic spending variation is due to this type of care. Part of the story is that Medicare pays for post-acute care in several different ways, with different implications for efficiency.

 For example, traditional Medicare (TM) - which spends ten percent of its total on post-acute care - pays skilled nursing facilities per diem rates but inpatient rehabilitation facilities a single payment per discharge. Post-acute care is also available through Medicare Advantage (MA), which operates under a global, per-enrollee, payment. Unlike TM, MA plans establish networks, may require prior authorization for post-acute care, and can charge more in cost-sharing for post-acute care than TM does.

These different payment models offer different incentives that may affect who receives care, in what setting, and for how long. In Health Affairs, Peter Huckfeldt, José Escarce, Brendan Rabideau, Pinar Karaca-Mandic, and Neeraj Sood assessed some of the consequences of those incentives.

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Last Updated on Friday, 16 June 2017 17:41
 


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