Panel: Regulation and Competition in the Long Term Care Sector
(Health Policy)

Friday, November 9, 2018: 1:30 PM-3:00 PM
8206 - Lobby Level (Marriott Wardman Park)

*Names in bold indicate Presenter

Panel Chairs:  Tony LoSasso, University of Illinois, Chicago
Discussants:  Seth Freedman, Indiana University and Miyeon Song, Texas A&M University

The Effect of Medicaid Fraud Enforcement on Nursing Home Quality
Victoria Perez and Coady Wing, Indiana University

Central Planning and Market Based Reforms: Evidence from Ohio’s Long-Term Care Market
Coady Wing, Indiana University, Joseph A Benitez, University of Louisville, Tony LoSasso, University of Illinois, Chicago and R. Tamara Konetzka, University of Chicago

Private Equity Ownership and Healthcare Billing Practices: Medicare Reimbursed Post-Acute Care in Skilled Nursing Facilities
John Bowblis, Miami University, Christopher Brunt, Georgia Southern University and Sean Huang, Georgetown University

Public Spending on Acute and Long-Term Care for Alzheimer’s Disease and Related Dementias
Lindsay L.Y. White, University of Washington and Norma B. Coe, University of Pennsylvania

The papers in this session examine the interplay between regulation, competition, and fraud in the Long Term Care (LTC) services sector of the health economy. Efforts to partially deregulate certificate of need laws in the LTC sector mean that market allocation mechanisms play a more important role in the sector than they did in the past. The first paper in the session studies the effects of a shift towards a market based cap-and-trade system for allocating licensed nursing home beds affected access to LTC services in Ohio. In another direction, recent changes in the role of private equity financing in the sector may help promote more efficient management practices in the LTC sector. However, it is also possible that a renewed focus on profit maximization may lead to higher rates of questionable billing practices. The second paper in the session, studies the way that private equity ownership affects patterns of overbilling and upcoding in skilled nursing facilities. Finally, there is substantial variation in the resources devoted to Medicaid fraud enforcement across states and over time. The third paper in the session studies the effects of higher levels of Medicaid fraud enforcement on the quality of care provided in many LTC facilities.

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