Medicare's Post-Acute Care Benefits: Background, Trends, and Issues to Be Faced

ASPE funded the Urban Institute to synthesize trends and issues with Medicare post-acute care benefits. Rapidly rising expenditures for home health, skilled nursing facility, and rehabilitation and long-term care hospital services have caused policymakers to focus considerable attention on these benefits. The Balanced Budget Act (BBA) of 1997 mandated a myriad of reforms, primarily payment reforms, for these services. However, long-standing coverage, eligibility, and certification policies remained largely unchanged. This paper summarizes what is known about Medicare's post-acute care benefits, including a discussion of trends in expenditures; characteristics and outcomes of post-acute care users; payment reforms included in the BBA; and cost, quality, and access issues not addressed by the BBA. [67 PDF pages]