A systems analysis of excess demand reimbursement rates and the quality of long term care in Kentucky

This paper examines the relationship between various determinants of quality in the Kentucky long-term care system. The levels of care are identified as skilled and intermediate. This paper investigates whether the relationship between low quality and a high percentage of Medicaid patients is attributable to the presence of low reimbursement rates or excess demand.; Some researchers have determined that reimbursement rates paid for Medicaid patients are constraining nursing homes from providing higher quality patient care. Alternatively, the quality equation can be attributed to the presence of excess demand eliminating the need to engage in quality competition for the less lucrative Medicaid patients.; This study utilizes data from 1989 and 1990 finding a significant relationship between Medicaid reimbursement rates, wages paid employees and the quality of care provided patients within Kentucky long-term care facilities.