Measuring function for Medicare inpatient rehabilitation payment.

We studied 186,766 Medicare discharges to the community in 1999 from 694 inpatient rehabilitation facilities (IRF). Statistical models were used to examine the relationship of functional items and scales to accounting cost within impairment categories. For most items, more independence leads to lower costs.

Posthospitalization home health care use and changes in functional status in a Medicare population.

Objective: The objective of this work was to estimate the effect of Medicare beneficiaries' use of home health care (HHC) for 6 months after hospital discharge on the change in functional status over a 1-year period beginning before hospitalization.

Data Sources And Study Setting: Data came from the Medicare Current Beneficiary Survey, which is a nationally representative sample of Medicare beneficiaries, in-person interview data, and Medicare claims for 1991 through 1994 for 2,127 nondisabled, community-dwelling, elderly Medicare beneficiaries who were hospitalized within 6 months of their annual in-person interviews.

Study Design: Econometric estimation with the instrumental variable method was used to correct for observational data bias, ie, the nonrandom allocation of discharged beneficiaries to the use of posthospitalization HHC.

Determinants and costs of Medicare post-acute care provided by SNFs and HHAs.

Provisions in the 1997 Balanced Budget Act affecting Medicare skilled nursing facility (SNF) and home health agency (HHA) services heighten the importance of knowing more about beneficiary, market, and policy factors that impact use of post-acute care and the costs of such services. This study used data from the Medicare Current Beneficiary Survey and other sources to address these issues. Findings shed light on responses that need to be monitored in light of the recently mandated policies and other SNF and HHA options that are being considered.