Medicare Patients and Postacute Care

Who Goes Where?

by C. Richard Neu, Scott Harrison, Joanna Heilbrunn


Download eBook for Free

FormatFile SizeNotes
PDF file 4.2 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.


Purchase Print Copy

 FormatList Price Price
Add to Cart Paperback96 pages $25.00 $20.00 20% Web Discount

As part of an effort to understand better the "natural history" of episodes of care among Medicare beneficiaries, this report documents patterns of postacute care use by Medicare patients and explores some factors that may explain these patterns. The research suggests that there are factors unrelated to a patient's medical condition that determine the setting in which postacute care is given. These factors include economic and social circumstances, and characteristics of the discharging hospital. Specifically, whites are significantly more likely to use skilled nursing facility (SNF) care than nonwhites, whereas nonwhites are significantly more likely to use home health care than whites. A similar pattern is repeated at the hospital level: Patients discharged from hospitals with a "disproportionate share" of Medicaid patients are less likely to receive SNF care but more likely to use home health care than are patients discharged from other hospitals. Because SNF and home health care appear to be substitutes for each other, policy measures that affect care in one of these settings will probably affect care in the other.

This report is part of the RAND Corporation Report series. The report was a product of the RAND Corporation from 1948 to 1993 that represented the principal publication documenting and transmitting RAND's major research findings and final research.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.