Incentives in case-mix measures for long-term care.
Smits, Helen L
Date of Pub
Several States now use patient-based payments for skilled nursing facilities and intermediate care facilities; others are
in the process of developing case-mix systems. The Health Care Financing Administration is working under congressional mandate
to develop a prospective case-mix system for Medicare payments to skilled nursing facilities. If new payment methods follow
the existing pattern, they will be based not on the patient's clinical characteristics but rather on a mixture of clinical
characteristics and services delivered. As a result, innate incentives are contained in data collection systems which are
cost-increasing at best and dangerous at worst. A preferable approach would be to develop payment schemes based on the patient's
degree of dependence.
Costs and Cost Analysis : Diagnosis-Related Groups : Intermediate Care Facilities/economics : Medicare : Nursing Homes/economics
: Prospective Payment System/methods : Reimbursement Mechanisms/methods : Skilled Nursing Facilities/economics : United States
: United States Health Care Financing Administration : West Virginia