{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:24:28Z","timestamp":1788870268459,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,3,2]],"date-time":"2015-03-02T00:00:00Z","timestamp":1425254400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Rackham Graduate School of the University of Michigan"},{"DOI":"10.13039\/100008591","name":"Fahs-Beck Fund for Research and Experimentation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008591","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100001502","name":"Blue Cross Blue Shield of Michigan Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100001502","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002630","name":"Ewha Womans University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002630","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the effect of the 10 percent cap introduced to Medicare home health care on treatment intensity and patient discharge status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Medicare Denominator, Medicare Home Health Claims, and Medicare Provider of Services Files from 2008 through 2010.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>We used agency\u2010level variation in the proportion of outlier payments prior to the implementation of the 10 percent cap to identify how home health agencies adjusted the number of home health visits and patient discharge status under the new law.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>Under the 10 percent cap, agencies dramatically decreased the number of service visits. Agencies also dropped relatively healthy patients and sent sicker patients to nursing homes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The drastic reduction in the number of service visits and discontinuation of relatively healthy patients from home health care suggest that the 10 percent cap improved the efficiency of home health services as intended. However, the 10 percent cap increased other types of health care expenditures by pushing sicker patients to use more expensive health services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.12290","type":"journal-article","created":{"date-parts":[[2015,3,2]],"date-time":"2015-03-02T19:14:52Z","timestamp":1425323692000},"page":"1606-1627","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of the Ten Percent Cap in Medicare Home Health Care on Treatment Intensity and Patient Discharge Status"],"prefix":"10.1111","volume":"50","author":[{"given":"Hyunjee","family":"Kim","sequence":"first","affiliation":[{"name":"Center for Health Systems Effectiveness Oregon Health &amp; Science University Portland OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward C.","family":"Norton","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management and Department of Economics University of Michigan NBER Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,3,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.28.4.1154"},{"key":"e_1_2_6_3_1","first-page":"86","article-title":"Medicare Program; Home Health Prospective Payment System Refinement and Rate Update for Calendar Year 2008; Proposed Rule","volume":"72","author":"CMS","year":"2007","journal-title":"Federal Register"},{"key":"e_1_2_6_4_1","first-page":"216","article-title":"Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2010; Final Rule","volume":"74","author":"CMS","year":"2009","journal-title":"Federal Register"},{"key":"e_1_2_6_5_1","unstructured":"CMS.2013. \u201cMedicare Claims Processing Manual\u201d [accessed on July 24 2014]. Available athttp:\/\/www.cms.gov\/Regulations-and-Guidance\/Guidance\/Manuals\/Internet-Only-Manuals-IOMs-Items\/CMS018912.html"},{"key":"e_1_2_6_6_1","unstructured":"CMS.2014. \u201cOutlier Payments\u201d [accessed on September 15 2014]. Available athttp:\/\/www.cms.gov\/Medicare\/Medicare-Fee-for-Service-Payment\/AcuteInpatientPPS\/outlier.html"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-6296(97)00042-8"},{"key":"e_1_2_6_8_1","first-page":"128","article-title":"Medicare Program; Prospective Payment System for Home Health Agencies; Final Rule","volume":"65","author":"HCFA","year":"2000","journal-title":"Federal Register"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781412985901"},{"key":"e_1_2_6_10_1","volume-title":"Report to the Congress: Medicare Payment Policy","author":"MedPAC","year":"2008"},{"key":"e_1_2_6_11_1","volume-title":"Report to the Congress: Medicare Payment Policy","author":"MedPAC","year":"2009"},{"key":"e_1_2_6_12_1","volume-title":"Report to the Congress: Medicare Payment Policy","author":"MedPAC","year":"2010"},{"key":"e_1_2_6_13_1","volume-title":"Report to the Congress: Medicare Payment Policy","author":"MedPAC","year":"2011"},{"key":"e_1_2_6_14_1","volume-title":"Report to the Congress: Medicare Payment Policy","author":"MedPAC","year":"2012"},{"key":"e_1_2_6_15_1","volume-title":"Report to the Congress: Medicare Payment Policy","author":"MedPAC","year":"2013"},{"key":"e_1_2_6_16_1","volume-title":"Report to the Congress: Medicare Payment Policy","author":"MedPAC","year":"2014"},{"key":"e_1_2_6_17_1","unstructured":"OIG.2009.Aberrant Medicare Home Health Outlier Payment Patterns in Miami\u2010Dade County and Other Geographic Areas in 2008(No. OEI\u201004\u201008\u201000570)."},{"key":"e_1_2_6_18_1","unstructured":"OIG.2011.Medicaid Hospital Outlier Payment Follow\u2010Up for Fiscal Years 2004 through 2006(No. A\u201007\u201010\u201004160)."},{"key":"e_1_2_6_19_1","unstructured":"OIG.2013.Medicare Hospital Outlier Payments Warrant Increased Scrutiny(No. OEI\u201006\u201010\u201000520)."},{"issue":"10","key":"e_1_2_6_20_1","first-page":"42","article-title":"Tough Negotiations in Store between Plans and Hospitals","volume":"12","author":"Silverman E.","year":"2003","journal-title":"Managed Care"}],"container-title":["Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1475-6773.12290","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1475-6773.12290","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T14:56:15Z","timestamp":1696344975000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1475-6773.12290"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3,2]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2015,10]]}},"alternative-id":["10.1111\/1475-6773.12290"],"URL":"https:\/\/doi.org\/10.1111\/1475-6773.12290","archive":["Portico"],"relation":{},"ISSN":["0017-9124","1475-6773"],"issn-type":[{"value":"0017-9124","type":"print"},{"value":"1475-6773","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3,2]]},"assertion":[{"value":"2015-03-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}