Impact of the BBA on Post-Acute Utilization

Long-term impact of medicare payment reductions on patient outcomes.

OBJECTIVE To examine the long-term impact of Medicare payment reductions on patient outcomes for Medicare acute myocardial infarction (AMI) patients. DATA SOURCES Analysis of secondary data compiled from 100 percent Medicare Provider Analysis and Review between 1995 and 2005, Medicare hospital cost reports, Inpatient Prospective Payment System Payment Impact Files, American Hospital Associati...

Overview: Medicare Post-Acute Care Since the Balanced Budget Act of 1997

contained the most sweeping changes in payment policy for Medicare post-acute care (PAC) services ever enacted in a single piece of legislation. Research on the early impacts of these changes is now beginning to appear, and this issue of the Health Care Financing Review includes six articles covering a range of timely PAC issues. There are two articles on skilled nursing facility (SNF) care—the...

Effect of cuts in Medicare reimbursement on process and outcome of care for acute myocardial infarction patients.

BACKGROUND The Balanced Budget Act (BBA) of 1997 was designed to reduce Medicare reimbursements by $116.4 billion from 1998 to 2002. The objective of this study was to determine whether the process of care for acute myocardial infarction (AMI) worsened to a greater degree in hospitals under increased financial strain from the BBA and whether vulnerable populations such as the uninsured were dis...

BBA Impacts on Hospital Residents, Finances, and Medicare Subsidies

Concern over rapidly rising Medicare expenditures prompted Congress to pass the 1997 Balanced Budget Act (BBA) that included provisions reducing graduate medical education (GME) payments and capped the growth in residents for payment purposes. Using Medicare cost reports through 2001, we find that both actual and capped residents continued to grow post-BBA. While teaching hospital total margins...

Implementing the BBA: the challenge of moving Medicare post-acute services to PPS.