Studying the impact of state Medicaid policy changes on the hospitalization of nursing home residents

The Foundation's Changes in Health Care Financing and Organization program was designed to support research, demonstration, and evaluation projects examining major changes in health care financing.The grantee will examine the effect of changes in state nursing home bed-hold payment policies. Bed-hold policies are designed to prevent facilities from discharging low paying (i.e., Medicaid), costly, or complicated patients and to encourage continuity of residence by continuing to reimburse nursing homes if a resident is transferred to a hospital.The researchers will study the impact of these policies on the rate of hospitalization of nursing home residents, as well as on whether residents return to their originating nursing home following hospital discharge. In particular, they would: (1) describe variation in the rates of hospitalization between 1999 and 2005; (2) describe changes in the pattern of post-hospitalization discharge locations; (3) test the effect of changes in state Medicaid bed-hold payment policies between 1999 and 2005 on the rate of all hospitalizations of long-stay nursing home residents; (4) test whether state bed-hold policies differentially affect the occurrence of "potentially avoidable" and "terminal" hospitalizations among nursing home residents; (5) test the effect of changes in state Medicaid bed-hold payment policies between 1999 and 2005 on the discharge location; (6) quantify the financial implications of changes in state bed-hold policies; and (7) examine changes in residents' functional status associated with hospitalization in the periods before and after changes in bed-hold policies. The objective of this study is to inform the debate about how best to address increasing hospitalizations of nursing home residents.

Grant Details

Amount Awarded $307,261.00

Awarded on: 4/25/2008

Time frame: 6/1/2008 - 6/30/2011

Grant Number: 64435


Brown University Warren Alpert Medical School

Box G-A
Providence, 02912-0001


Vincent Mor
Project Director