Table 10. Time-Series and Cross-Sectional Analysis of Medicaid Nursing Home per Diem Rates, by Reimbursement System and Case Mix: 1987-89.
| Random-Effects Model Coefficient and (t-Score) for: | Medicaid per Diem Reimbursement Rates | |||
|---|---|---|---|---|
|
| ||||
| SNF | ICF | |||
|
|
|
|||
| Inflation Adjusted | Not Adjusted | Inflation Adjusted | Not Adjusted | |
| Intercept | 142.31 | 130.71 | 131.23 | 121.44 |
| Year in Period |
12.44 (10.36) |
15.46 (19.80) |
11.09 (5.26) |
13.13 (11.87) |
| Has Case Mix | −0.21 (−0.10) |
0.91 (0.36) |
−0.46 (−0.30) |
−0.20 (−0.10) |
| Prospective Facility-Specific | 2.77 (1.46) |
3.49 (1.58) |
43.27 (2.44) |
43.72 (2.17) |
| Prospective Class | −3.62 (−0.96) |
−3.66 (−0.84) |
1.86 (0.68) |
2.57 (0.74) |
| Combination Prospective-Retrospective | −2.72 (−0.91) |
−5.05 (−1.43) |
0.55 (0.27) |
−0.13 (−0.05) |
| Prospective Adjusted | 3.01 (1.37) |
27.85 (3.07) |
27.70 (4.57) |
213.54 (6.34) |
| Interactions—Year by: | ||||
| Has Case Mix | −0.47 (−1.21) |
3−0.92 (−2.04) |
−0.24 (−0.90) |
−0.55 (−1.61) |
| Prospective Facility-Specific |
1−1.65 (−5.68) |
1−2.55 (−7.49) |
−0.24 (−1.04) |
3−0.52 (−1.73) |
| Prospective Class |
1−1.89 (−5.08) |
1−3.19 (−7.27) |
1−1.07 (−3.77) |
3−1.76 (−4.82) |
| Combination Prospective-Retrospective | −0.57 (−0.99) |
3−1.36 (−2.00) |
0.40 (1.02) |
0.41 (0.81) |
| Prospective, Adjusted |
1− 1.43 (−4.69) |
1−2.24 (−6.26) |
−0.06 (−0.27) |
−0.29 (−0.94) |
| N5 = 542 | ||||
| Mean (dollars) = | 50.09 | 51.61 | 39.52 | 40.71 |
| R-Square, Fixed Effects Model | 20.904 | 20.902 | 20.928 | 20.911 |
| R-Square Group Effects Only | 0.862 | 0.681 | 0.888 | 0.699 |
| R-Square Increase6 | 20.042 | 20.220 | 20.040 | 20.212 |
Significant at .01 level, using one-tailed tests for coefficients.
Significant at .01 level, using two-tailed test in the absence of a directional hypothesis.
Significant at .05 level, using one-tailed tests for coefficients.
Significant at .05 level, using two-tailed test in the absence of a directional hypothesis.
There are 8 missing cases in 50 States for 11 years.
A random-effects model is used. What Is reported, however, is the increment in variance explained for full model over model containing only group (State) effects.
NOTES: Numbers in parentheses are t-scores. SNF is skilled nursing facility. ICF is intermediate care facility.
SOURCE: Institute for Health and Aging and National Governors' Association: State Medicaid Reimbursement Survey, San Francisco, 1989.