FACTORS INFLUENCING THE USE OF MEDICARE'S SNFS BENEFIT

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This study will analyze data collected by the national study of Medicare post acute care use by Medicare beneficiaries in three urban areas: Minneapolis/St. Paul, Minnesota; Houston, Texas; and Pittsburgh, Pennsylvania. Selected data from this national study of a random sample of 2,687 Medicare beneficiaries in five DRG categories will be used to assess the influence of patient and hospital specific characteristics on the use of post acute SNF services. The results of this study will provide descriptive information on the types of patients using SNF services and discern particular patterns of SNF use among Medicare beneficiaries. The study will also look at the nursing homes' role in determining initial Medicare eligibility for Medicare's SNF benefit. Once a patient has been admitted to a Medicare certified SNF, there should be no non-care related factors associated with the SNFs decision to bill Medicare. Yet, given the retroactive nature of Medicare denials and uncertainty of coverage, nursing homes may be more willing to seek Medicare coverage for certain patients and less willing for others. This part of the study will be based on the 587 Medicare patients transferred from the hospital to a skilled nursing facility. The patient specific data file will be supplemented with information collected from the nursing facilities as to primary and other payment sources, whether a bill was filed with Medicare, whether it was paid and for how long. The analysis will use a sequential logit regression.