In 1998, Medicare adopted a per diem Prospective Payment System (PPS) for skilled nursing facility care, which Basket Blazer Bebe was intended to deter the use of high-cost rehabilitative services. The average per diem decreased under the PPS, but because per diems increased for greater therapy minutes, the ability of the PPS to deter the use of high-intensity services was questionable. In this study, we assess how the PPS affected the volume and intensity of Medicare services. By volume we mean the product of the number of Medicare residents in a facility and the average length-of-stay, by intensity we mean the time per week devoted to rehabilitation therapy. Our results indicate that the number of Medicare residents decreased under PPS, but rehabilitative services and therapy minutes increased while length-of-stay remained relatively constant. Not surprisingly, when subsequent Medicare policy changes increased payment rates, Medicare Acheter Chaussure Nike Blazer Homme Pas Cher Blazer Homme volume far surpassed the levels seen in the pre-PPS period.
In this article, I juxtapose the experiences of the working-class, young woman I was 30 years ago and the “middle-class” academic researcher that I have become with an attempt to theorise the difficult relationship of Women’s Studies to the academy in the U.K. I exemplify the ways in which the issue of women’s social class is particularly problematic for Women’s Studies by drawing on my own personal history of being working-class in the British higher education system. I maintain that, just as my sense of integrity and autonomy as a working-class woman was continually under assault in higher education, the position of Women’s Studies in the academy is also about “surviving in dangerous places,” which continually jeopardises Women’s Studies’ aim of validating women’s experiences across social classes. Drawing on my recent experience I argue that issues of co-option, insecurity, and lack of authenticity are also hallmarks of Women’s Studies in the late 1990s.
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