Medicare spends more than $30 billion a year on nursing home care services for program beneficiaries. While these services can be valuable to Medicare beneficiaries and their families, concerns about spending growth and facility overpayment have led program officials to look for ways to cut costs. Researchers at W&M's Schroeder Center for Health Policy have partnered with Swarthmore College to study what happens when Medicare cuts the rates it pays to nursing homes. This year, the group was awarded a grant from the Agency for Healthcare Research and Quality to conduct empirical research using data on nearly 15,000 nursing facilities around the U.S.
The researchers on the project include W&M professors Peter McHenry and Jennifer Mellor and Professor Daifeng He of Swarthmore College. The team will study the impact of reductions in Medicare payments on patients – both those who enroll in Medicare and those who pay through other means, such as Medicaid or private insurance. “Our project has three primary goals,” explained Mellor. “We want to look at the impacts on payment changes on first, the amount of care patients receive, and second, the quality of the care they receive. If payment cuts led to reductions in staffing, for example, patients might experience increases in pressure sores, or infections.” The third goal of the researchers is to look at whether the effects vary depending on market and policy conditions. For example, are nursing homes hit harder by payment cuts in highly competitive markets, or when Medicaid payment rates are relatively low?
The team will complete their research by summer 2019 and plans to present their findings at a national conference. Since the payment changes studied in the project are similar to provisions in the ACA, their findings have the potential to impact policy under the current healthcare law.