Practice Patterns among Entrants and Incumbents in the Home Health Market after the Prospective Payment System was Implemented
研究了按预期支付系统实施后，家庭健康机构新进入者与在位者在利用医保政策上的策略差异，发现新进入者更倾向采取策略性实践模式，且营利性在位者会模仿新进入者的某些做法，这有助于解释家庭健康支出快速增长。
Home health care expenditures were the fastest growing part of Medicare from 2001-2009, despite the implementation of prospective payment. Prior research has shown that home health agencies adopted two specific strategies to take advantage of Medicare policies: provide at least 10 therapy visits to get an enormous marginal payment and recertify patients for additional episodes. We study whether there is heterogeneity in the adoption of those strategic behaviors between home health agency entrants and incumbents and find that entrants were more likely to adopt strategic practice patterns than were incumbents. We also find that for-profit incumbents mimicked one of the practice patterns following entrants in the same market. Our findings suggest that it is important to understand the heterogeneity in providers' behavior and how firms interact with each other in the same market. These findings help explain the rapid rise in expenditures in the home health care market.