Working Paper: NBER ID: w12361
Authors: David C. Grabowski; Jonathan Gruber; Joseph J. Angelelli
Abstract: There has been much debate among economists about whether nursing home quality is a public good across Medicaid and private-pay patients within a common facility. However, there has been only limited empirical work addressing this issue. Using a unique individual level panel of residents of nursing homes from seven states, we exploit both within-facility and within-patient variation in payer source and quality to examine this issue. We also test the robustness of these results across states with different Medicaid and private-pay rate differentials. Across our various identification strategies, the results generally support the idea that quality is a public good within nursing homes. That is, within a common nursing home, there is very little evidence to suggest that Medicaid-funded residents receive consistently lower quality care relative to their private-paying counterparts.
Keywords: nursing home quality; public good; Medicaid; private pay; healthcare policy
JEL Codes: I11; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| payer source (H51) | quality of care (I11) |
| nursing home quality is a public good (H41) | quality of care (I11) |
| Medicaid-funded residents (I18) | quality of care (I11) |
| private-paying residents (H49) | quality of care (I11) |