Care for the chronically ill: nursing home incentive payment experience.
Weissert, William G
Date of Pub
Scanlon, William J; Skinner, Douglas E; Wan, Thomas T
Nursing home reimbursement systems which do not adjust payment levels to patient care needs lead to access problems for heavy-care
patients. Unnecessarily long and costly hospital stays may result. A patient-based nursing home incentive reimbursement system
has been designed and is being evaluated in a controlled field experiment in 36 California skilled nursing facilities. Incentives
are paid for admitting heavy-care patients, meeting outcome goals on some patients, and discharging and maintaining some patients
in the community. This article describes a nursing home reimbursement system which is intended to simultaneously mitigate
problems of restricted access, inefficient use of beds, and nonoptimal care. It also discusses the approach to evaluating
this broad social intervention by application of a controlled experimental design.
Costs and Cost Analysis : Diagnosis-Related Groups : Reimbursement Mechanisms : Reimbursement, Incentive : California : Chronic
Disease : Human : Medicaid : Nursing Homes/economics : Pilot Projects : Task Performance and Analysis