Impact of Postdischarge Follow-Up Care on Medicare Expenditures: Does Rural Make a Difference?. (June 2018)

• Record Type: Journal Article
• Authors: Toth, Matthew; Holmes, Mark; Toles, Mark; Van Houtven, Courtney; Weinberger, Morris; Silberman, Pam
• Is Part Of: Medical care research and review. Volume 75:Number 3(2018)
• Page Start: 327
• Page End: 353
• Publication Date: 2018-06
• Subjects: medicare -- postdischarge -- expenditures -- rural -- follow-up care; Medical care -- United States -- Periodicals; Medical care -- Periodicals; Medical care -- Research -- United States -- Periodicals; Medical care -- Research -- Periodicals; Medical economics -- United States -- Periodicals; Medical economics -- Periodicals; 362.10973
• DOI: 10.1177/1077558716687499
• Languages: English
• ISSNs: 1077-5587

Abstract

Reducing postdischarge Medicare expenditures is a key focus for hospitals. Early follow-up care is an important piece of this focus, but it is unclear whether there are rural–urban differences in the impact of follow-up care on Medicare expenditures. To assess this difference, we use the Medicare Current Beneficiary Survey, Cost and Use Files, 2000-2010. We conduct a retrospective analysis of 30-day postdischarge Medicare expenditures using two-stage residual inclusion with a quantile regression, where the receipt of 7-day follow-up care was the main independent variable. Postdischarge follow-up care increased the 25th percentile of 30-day expenditures, decreased the 75th percentile, and there were no rural–urban differences. Partial effects show postdischarge follow-up care resulted in higher 30-day expenditures among low-cost rural beneficiaries. Ensuring early follow-up care for high-cost beneficiaries may be advantageous to both rural and urban providers in helping reduce postdischarge Medicare expenditures.