Impact of Medicare on the Organization of Community Health Resources

One phase of a follow-up study of the effects of Medicare on health services to the elderly in a Midwestern, metropolitan community is reported. The original study, covering 1966 to 1968, reported almost no change in the organization and delivery of health services in five midwestern study sites. This study was conducted in 1971-72 (1) to re-examine the attitudes of managers of community health resources to Medicare-related decisions about coordinating their services; and (2) to assess any changes in physicians, attitudes to Medicare and their health care practices for elderly patients. Medicare has not appreciably changed the organization of health care services. Specifically, (1) most physicians had not altered methods of practice although they explicitly recognized the need for other levels of care; (2) hospital administrators reported that few plans made in 1966-67 to expand facilities and services had been carried out and that no further Medicare-related change in services was contemplated; (3) nursing home beds increased, but ECF beds declined. There was no coordination between nursing homes and hospitals, although some hospitals affiliated with ECFs; (4) home health services increased rapidly but Medicare-reimbursed services declined after 1969; and (5) a minority of providers found the local CHP agency effective; many did not know it existed. The importance of these findings for pending health care legislation is discussed.

Author(s): Rodney M. Coe; Henry P. Brehm; Warren A. Peterson

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Volume 52, Issue 3 (pages 231–264)
Published in 1974