Access to Posthospital Care for Medicare Beneficiaries

T-PEMD-87-1: Published: Jan 28, 1987. Publicly Released: Jan 28, 1987.

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GAO testified on its study of Medicare beneficiaries' access to post-hospital care, specifically: (1) the extent of reported problems and changes to those problems over time; (2) regional and urban/rural variations; and (3) the reasons for difficult post-hospital placements. GAO noted that 11.5 million elderly individuals received Medicare benefits during their hospitalization and some continued to use those benefits in nursing homes and home health care programs after their discharge from the hospitals. GAO found that: (1) 97 percent of the discharge planners experienced problems in placing Medicare patients in skilled nursing facilities and 86 percent had problems helping patients who needed home health care, due to Medicare rules and regulations; (2) the planners' problems included a lack of available skilled nurses, intermediate care beds, and chronic care resources; (3) an increase in Medicare patients and the use of complex medical equipment and high-tech services contributed to the planners' difficulty in placing patients in post-hospital care; and (4) views of the health care problems varied among the different regions. GAO noted that planners believe that: (1) placement problems are worse now than in the past; (2) eligibility and coverage criteria are more restrictive than in the past; and (3) Medicare does not cover the types of nonskilled services that many elderly need in order to stay at home.

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