TABLE 1.
Full study population | Treatment group only, by type of stay | ||||
---|---|---|---|---|---|
Treatment | Comparison | Long‐term care residents | Skilled care residents | ||
Measure | (N = 9608) | (N = 24,620) | Standardized difference | (N = 7194) | (N = 2414) |
Patient characteristics | |||||
Age at enrollment | 80 | 80 | 0.05 | 81 | 79 |
Female, % | 65 | 65 | 0.01 | 66 | 62 |
White, % | 94 | 93 | 0.05 | 95 | 93 |
Medicare/Medicaid dual status a , % | 30 | 30 | −0.02 | 33 | 18 |
Days between admission and enrollment: 0, % | 39 | 39 | 0 | 22 | 92 |
Days between admission and enrollment: 1–180, % | 10 | 10 | 0 | 11 | 7 |
Days between admission and enrollment: 181+, % | 51 | 51 | 0 | 68 | 2 |
HCC score b | 2.3 | 2.4 | −0.05 | 2.2 | 2.7 |
COPD, % | 26 | 27 | −0.02 | 25 | 27 |
CHF, % | 34 | 35 | −0.02 | 33 | 37 |
Morbid obesity, % | 8 | 8 | −0.02 | 7 | 9.2 |
Vascular disease, % | 31 | 29 | 0.03 | 33 | 25 |
Major depressive disorder, % | 11 | 11 | 0 | 12 | 9.1 |
RUG‐IV case‐mix index at admission c | 42 | 42 | −0.01 | 40 | 49 |
RUG‐IV group: rehabilitation, % | 78 | 79 | −0.01 | 73 | 95 |
RUG‐IV group: reduced physical function, % | 10 | 10 | 0.02 | 13 | 2 |
RUG‐IV group: clinically complex, % | 4 | 4 | −0.01 | 5 | 2 |
Service use and expenditures | |||||
Number of hospital admissions (per 1000) | 1002 | 1058 | −0.04 | 824 | 1533 |
Number of outpatient ED visits (per 1000) | 919 | 892 | 0.02 | 871 | 1064 |
Total Medicare expenditures ($ PBPM) | 2274 | 2423 | −0.05 | 2060 | 2912 |
Facility characteristics | |||||
Facility state: Iowa, % | 23 | 23 | 0 | 26 | 13 |
Facility state: Minnesota, % | 10 | 10 | 0 | 9 | 14 |
Facility state: Nebraska or South Dakota, % | 68 | 68 | 0 | 66 | 73 |
Rural facility, % | 64 | 64 | 0 | 65 | 59 |
Nonprofit facility, % | 37 | 43 | −0.13 | 38 | 34 |
Number of federally certified beds | 93 | 94 | −0.03 | 93 | 94 |
Nursing home compare 5‐star rating | 3.1 | 3.1 | −0.04 | 3.1 | 3.1 |
Note: All beneficiary characteristics were measured during or as of the end of the baseline year, which is defined as the 365 days before each beneficiary's enrollment date. The statistics are weighted means, with beneficiary weights proportional to the number of months during the 12‐month baseline period that the beneficiary was enrolled in both Medicare Parts A and B. In addition, statistics for comparison beneficiaries are weighted to reflect the size of its match set (i.e., the number of comparison beneficiary matched to a treatment beneficiary). Facility characteristics are summarized from the beneficiary‐level data. The reference group for nonprofit facilities are for‐profit facilities. Public facilities are excluded from the study. Standardized differences are calculated as the ratio of the difference in means and standard deviation of the variable estimated on the treatment group.
Abbreviations: CHF, congestive heart failure; CMS, Centers for Medicare & Medicaid Services; COPD, chronic obstructive pulmonary disorder; ED, emergency department; ESRD, end‐stage renal disease; HCC, hierarchical condition category; PBPM, per beneficiary per month; RUG, resource utilization group.
Includes residents with both a disability and ESRD.
The HCC score incorporates diagnosis history and demographics to estimate a score representing the expected costs of a Medicare beneficiary in the upcoming year. A score of one represents average expected expenditures. HCC scores were calculated by using the most recently available HCC algorithms.
Case‐mix index is an integer ranking of the RUG Codes based on the total Medicare rate, and reflects the relative resources predicted to provide care to a resident. A case‐mix index is designated to each RUG under the CMS RUG‐IV system. The higher the case‐mix index, the greater the resource requirements for the resident.