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Asian Development Bank InstituteThe Working Paper series is a continuation of the formerly named Discussion Paper series; the numbering of the papers continued without interruption or change. ADBI's working papers reflect initial ideas on a topic and are posted online for discussion. ADBI encourages readers to post their comments on the main page for each working paper (given in the citation below). Some working papers may develop into other forms of publication.ADB recognizes "China" as the People's Republic of China, and "Korea" as the Republic of Korea. In this publication, "$" refers to US dollars. Unless otherwise stated, boxes, figures, and tables without explicit sources were prepared by the authors. The views expressed in this paper are the views of the author and do not necessarily reflect the views or policies of ADBI, ADB, its Board of Directors, or the governments they represent. ADBI does not guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequences of their use. Terminology used may not necessarily be consistent with ADB official terms.Working papers are subject to formal revision and correction before they are finalized and considered published.Asian Development Bank Institute Kasumigaseki Building, 8th Floor 3-2-5 Kasumigaseki, Chiyoda-ku Tokyo 100-6008, JapanTel:+81-3-3593-5500 Fax:+81-3-3593-5571 URL:www.adbi.org E-mail: info@adbi.org © 2017 Asian Development Bank Institute ADBI Working Paper 680 E. C. Norton
AbstractThe Center for Medicare and Medicaid Services has introduced several pay-for-performance programs in the last few years to encourage hospitals to improve quality of care and reduce costs. Some state Medicaid programs have also introduced pay-for-performance for nursing homes. Long-term care providers play an important role in hospital pay-for-performance programs because they can affect the readmission rate and also total episode payments. A good pay-for-performance program will focus on improving quality of care that affects health outcomes. In addition, that quality must vary across providers and be measurable. Furthermore, it is important that the measures be reported in a timely way, that both demand and supply respond to the measures, and that the measures be risk adjusted. Empirical data from Medicare beneficiaries in the state of Michigan show that mean episode payments and readmission rates in skilled nursing facilities vary widely and are...