Evaluation of the ACCESS: Medicare Long-Term Care Demonstration Project. Executive Summary

摘要

The ACCESS:Medicare demonstration focused on reduction of administrative hospital days for long term care clients. A quasi-experimental comparative study research design was used to assess participant outcomes and cost-effectiveness of the demonstration. Performance variables, such as impact of the program on participant mortality, and process variables were analyzed in the evaluation. Results were analyzed separately for the Medicare Private Pay Group and the Medicare/Medicaid Group. The following is a summary of the study's findings: ACCESS:Medicare significantly reduced hospital utilization for both program groups relative to the comparison group. Utilization of skilled nursing facility (SNF) and home care services increased for both program groups. Total hospital costs and outpatient service costs were not significantly reduced for the Medicare Private Pay Group, and total costs of SNF and home care services increased. For the dual eligible Medicare/Medicaid Program Group, the demonstration reduced hospital costs; had no impact on either nursing home or outpatient service costs; and significantly increased the costs of home care.