Abstract
The implementation of Medicare's prospective pay ment system has precipitated the question of whether incentives to reduce inpatient admissions and lengths of inpatient stays have an adverse effect upon quality. A primary focus on quality under prospective pay ment is premature discharge and subsequent read mission. This problem suggests a new "breed" of pa tients who require alternative levels of care. The combination of the geriatric team approach with that of alternate levels of care seeks to decrease the inci dence of readmission resulting from inadequate edu cation and preparation for discharge.

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