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Prospective payment for Medicare inpatient psychiatric care: assessing the alternatives.

Cotterill PG, Thomas FG - Health Care Financ Rev (2004)

Bottom Line: This article reports the findings of an empirical analysis of per case and per diem models of prospective payment for Medicare inpatient psychiatric care.Quantitative measures are presented that show the improvement of a per diem model over a per case model.The research supports the viability of per diem prospective payment and identifies directions for future research that would refine current per diem models.

View Article: PubMed Central - PubMed

Affiliation: Centers for Medicare & Medicaid Services, Baltimore, MD 21244-1850, USA. pcotterill@cms.hhs.gov

ABSTRACT
This article reports the findings of an empirical analysis of per case and per diem models of prospective payment for Medicare inpatient psychiatric care. Quantitative measures are presented that show the improvement of a per diem model over a per case model. The research supports the viability of per diem prospective payment and identifies directions for future research that would refine current per diem models.

Show MeSH
Payment System Bias
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Related In: Results  -  Collection


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f1-hcfr-26-1-085: Payment System Bias

Mentions: Since we have equated aggregate payments and aggregate costs for each system, the slope coefficient of the cost-payment regressions measures the relationship between the levels of per case costs and payments. Hence, for each payment model, the slope indicates whether there is a systematic bias toward over or under payment relative to cost. A slope greater than 1.0 indicates that for low levels of per case payment, payment tends to be less than cost, and for high levels of per case payment, payment tends to exceed cost. The converse is true for a slope less than 1.0: at low per case payment levels, payment tends to exceed cost, and at high per case payment levels, payment tends to be less than cost (Figure 1). As the slope coefficient pivots from either greater or less than 1.0 toward 1.0, the areas of systematic differences between cost and payment decrease. For systems where aggregate costs and payments are equal, the regression lines for alternative systems rotate through a common point of intersection, which represents the coordinates of the mean values of the cost and payment variables. More precisely, there will be a single point of intersection when the analysis is conducted at the case level.3


Prospective payment for Medicare inpatient psychiatric care: assessing the alternatives.

Cotterill PG, Thomas FG - Health Care Financ Rev (2004)

Payment System Bias
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194879&req=5

f1-hcfr-26-1-085: Payment System Bias
Mentions: Since we have equated aggregate payments and aggregate costs for each system, the slope coefficient of the cost-payment regressions measures the relationship between the levels of per case costs and payments. Hence, for each payment model, the slope indicates whether there is a systematic bias toward over or under payment relative to cost. A slope greater than 1.0 indicates that for low levels of per case payment, payment tends to be less than cost, and for high levels of per case payment, payment tends to exceed cost. The converse is true for a slope less than 1.0: at low per case payment levels, payment tends to exceed cost, and at high per case payment levels, payment tends to be less than cost (Figure 1). As the slope coefficient pivots from either greater or less than 1.0 toward 1.0, the areas of systematic differences between cost and payment decrease. For systems where aggregate costs and payments are equal, the regression lines for alternative systems rotate through a common point of intersection, which represents the coordinates of the mean values of the cost and payment variables. More precisely, there will be a single point of intersection when the analysis is conducted at the case level.3

Bottom Line: This article reports the findings of an empirical analysis of per case and per diem models of prospective payment for Medicare inpatient psychiatric care.Quantitative measures are presented that show the improvement of a per diem model over a per case model.The research supports the viability of per diem prospective payment and identifies directions for future research that would refine current per diem models.

View Article: PubMed Central - PubMed

Affiliation: Centers for Medicare & Medicaid Services, Baltimore, MD 21244-1850, USA. pcotterill@cms.hhs.gov

ABSTRACT
This article reports the findings of an empirical analysis of per case and per diem models of prospective payment for Medicare inpatient psychiatric care. Quantitative measures are presented that show the improvement of a per diem model over a per case model. The research supports the viability of per diem prospective payment and identifies directions for future research that would refine current per diem models.

Show MeSH