Medicare Post-Acute Care: Better Information Needed Before Modifying BBA Reforms: T-HEHS-99-192

September 1999
GAO Reports;9/15/1999, p1
Government Documents
The Balanced Budget Act of 1997 seeks to make Medicare a more efficient and prudent purchaser of post-acute care services. The act's payment reforms are changing home health care, skilled nursing facility, and rehabilitation therapy service delivery practices. There is still not enough information to distinguish desirable from undesirable consequences, so that calls to amend or repeal the Act are premature. But imperfections in the design of the payment system require attention. The prospective payment system is an appropriate long-term tool for access to Medicare's home health benefits but will require adjustment when more information on cost, use, and users becomes available. The Health Care Financing Administration is working on a solution to the problem that prospective payment system rates may underpay for high-cost skilled nursing facility care, leading to beneficiaries' staying longer in acute care hospitals. A system for basing outpatient rehabilitation therapy payments on need, rather than on dollar caps, might help better target the beneficiaries who genuinely require services.


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