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Measuring function for Medicare inpatient rehabilitation payment.

Carter GM, Relles DA, Ridgeway GK, Rimes CM - Health Care Financ Rev (2003)

Bottom Line: For most items, more independence leads to lower costs.However, two items are not associated with cost in the expected way.We present the rules used to construct administratively simple, homogeneous, resource use groups that provide reasonable incentives for access and quality care and that determine payments under the new IRF prospective payment system (PPS).

View Article: PubMed Central - PubMed

Affiliation: grace_carter@rand.org

ABSTRACT
We studied 186,766 Medicare discharges to the community in 1999 from 694 inpatient rehabilitation facilities (IRF). Statistical models were used to examine the relationship of functional items and scales to accounting cost within impairment categories. For most items, more independence leads to lower costs. However, two items are not associated with cost in the expected way. The probable causes of these anomalies are discussed along with implications for payment policy. We present the rules used to construct administratively simple, homogeneous, resource use groups that provide reasonable incentives for access and quality care and that determine payments under the new IRF prospective payment system (PPS).

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Related in: MedlinePlus

Density of Cases with Each Motor Score for Stroke and Lower Extremity Joint Replacement: 1999
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Related In: Results  -  Collection


getmorefigures.php?uid=PMC4194823&req=5

f1-hcfr-24-3-025: Density of Cases with Each Motor Score for Stroke and Lower Extremity Joint Replacement: 1999

Mentions: Figure 1 shows the distribution of the motor score minus the transfer to tub item for stroke and lower extremity joint replacement. There is almost a normal distribution in each RIC, but the stroke cases have a much larger standard deviation. Unlike the motor scores, the shape of the cognitive score distribution depends strongly on RIC (Figure 2). There is much more variation across cases in the stroke RIC.


Measuring function for Medicare inpatient rehabilitation payment.

Carter GM, Relles DA, Ridgeway GK, Rimes CM - Health Care Financ Rev (2003)

Density of Cases with Each Motor Score for Stroke and Lower Extremity Joint Replacement: 1999
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194823&req=5

f1-hcfr-24-3-025: Density of Cases with Each Motor Score for Stroke and Lower Extremity Joint Replacement: 1999
Mentions: Figure 1 shows the distribution of the motor score minus the transfer to tub item for stroke and lower extremity joint replacement. There is almost a normal distribution in each RIC, but the stroke cases have a much larger standard deviation. Unlike the motor scores, the shape of the cognitive score distribution depends strongly on RIC (Figure 2). There is much more variation across cases in the stroke RIC.

Bottom Line: For most items, more independence leads to lower costs.However, two items are not associated with cost in the expected way.We present the rules used to construct administratively simple, homogeneous, resource use groups that provide reasonable incentives for access and quality care and that determine payments under the new IRF prospective payment system (PPS).

View Article: PubMed Central - PubMed

Affiliation: grace_carter@rand.org

ABSTRACT
We studied 186,766 Medicare discharges to the community in 1999 from 694 inpatient rehabilitation facilities (IRF). Statistical models were used to examine the relationship of functional items and scales to accounting cost within impairment categories. For most items, more independence leads to lower costs. However, two items are not associated with cost in the expected way. The probable causes of these anomalies are discussed along with implications for payment policy. We present the rules used to construct administratively simple, homogeneous, resource use groups that provide reasonable incentives for access and quality care and that determine payments under the new IRF prospective payment system (PPS).

Show MeSH
Related in: MedlinePlus