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@techreport{NBERw22598,
 title = "Strategic Patient Discharge: The Case of Long-Term Care Hospitals",
 author = "Eliason, Paul J and Grieco, Paul L. E and McDevitt, Ryan C and Roberts, James W",
 institution = "National Bureau of Economic Research",
 type = "Working Paper",
 series = "Working Paper Series",
 number = "22598",
 year = "2016",
 month = "September",
 doi = {10.3386/w22598},
 URL = "http://www.nber.org/papers/w22598",
 abstract = {Medicare's prospective payment system for long-term acute-care hospitals (LTCHs) pro- vides modest reimbursements at the beginning of a patient's stay before jumping discontinuously to a large lump-sum payment after a pre-specified number of days. We show that LTCHs respond to financial incentives by disproportionately discharging patients after they cross the large-payment threshold, resulting in worse outcomes for patients. We find this occurs more often at for-profit facilities, facilities acquired by leading LTCH chains, and facilities co-located with other hospitals. Using a dynamic structural model, we evaluate counterfactual payment policies that would provide substantial savings for Medicare without adversely affecting patients.},
}