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Health Affairs, Vol 17, Issue 4, 184-197
Copyright © 1998 by Project HOPE

DataWatch

What does Medicare pay for? Disentangling the flow of funds to health care providers

Many Medicare policies pertain to only part of an expenditure category for which there are publicly available data. Integrating three types of data sources, this DataWatch disaggregates Medicare spending by type of provider. It also disaggregates payments to hospital outpatient departments by type of service. The results reveal a number of patterns obscured by more aggregate figures. For instance, although Medicare pays for most skilled nursing facility (SNF) services through Part A, Part B paid SNFs almost a billion dollars for rehabilitation services in fiscal year 1996. The recipients were not eligible for Part A SNF benefits but were residents of nursing homes.

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