Incentivizing Better Quality of Care: The Role of Medicaid and Competition in the Nursing Home Industry
NBER Working Paper No. 24133
Issued in December 2017
NBER Program(s):Aging, Health Care, Health Economics, Industrial Organization, Public Economics
This paper develops a model of the nursing home industry to investigate the quality effects of policies that either raise regulated reimbursement rates or increase local competition. Using data from Pennsylvania, I estimate the parameters of the model. The findings indicate that nursing homes increase the quality of care, measured by the number of skilled nurses per resident, by 8.8% following a universal 10% increase in Medicaid reimbursement rates. In contrast, I find that pro-competitive policies lead to only small increases in skilled nurse staffing ratios, suggesting that Medicaid increases are more cost effective in raising the quality of care.
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Document Object Identifier (DOI): 10.3386/w24133
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