Medicare's prospective payment system (PPS) created incentives for the early discharge of hospitalized patients to sub-acute care: skilled nursing and intermediate care facilities, home health agencies, and long-term care hospitals. This study by Michael Morrisey, Frank Sloan, and Joseph Valvona examines changes in the proportion of patients transferred, the length-of-stay prior to transfer, and mean case-mix complexity of transferred patients. Their conclusions raise a number of issues for health policy and health care management.
