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Old and Sick in AmericaThe Journey through the Health Care System$
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Muriel R. Gillick

Print publication date: 2017

Print ISBN-13: 9781469635248

Published to North Carolina Scholarship Online: May 2018

DOI: 10.5149/northcarolina/9781469635248.001.0001

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Movers and Shapers

Movers and Shapers

Chapter:
(p.184) Chapter Eleven Movers and Shapers
Source:
Old and Sick in America
Author(s):

Muriel R. Gillick M.D.

Publisher:
University of North Carolina Press
DOI:10.5149/northcarolina/9781469635248.003.0011

Nursing home administrators, physicians, hospitals, drug companies, and Medicare are among the major influences on the patient’s experience of skilled nursing facility (SNF) care. Administrators are concerned with selecting patients with high levels of Medicare reimbursement; physicians tend to regard SNF care as low status and unrewarding; hospitals use the SNF as a safety valve allowing for early discharge; drug companies work with regional medical distributors to influence physician prescribing; and Medicare tries to promote quality by using an elaborate system of quality indicators, mandating state inspections or surveys, and reimbursing care so as to encourage maximal use of physical therapy.

Keywords:   Quality indicators, Rehabilitation, Survey, Regulation

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