Executive Summary of Analyses for the Initial Implementation of the Inpatient Rehabilitation Facility Prospective Payment System PDF Download
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Author: Grace M. Carter Publisher: RAND Corporation ISBN: 9780833031297 Category : Hospital patients Languages : en Pages : 0
Book Description
This report describes the research that RAND performed to support the efforts of the Health Care financing Administration to design, develop, and implement a Prospective Payment System for inpatient rehabilitation.
Author: Grace M. Carter Publisher: RAND Corporation ISBN: 9780833031297 Category : Hospital patients Languages : en Pages : 0
Book Description
This report describes the research that RAND performed to support the efforts of the Health Care financing Administration to design, develop, and implement a Prospective Payment System for inpatient rehabilitation.
Author: Publisher: ISBN: Category : Hospitals Languages : en Pages : 34
Book Description
In the Balanced Budget Act of 1997, Congress mandated that the Health Care Financing Administration (HCFA) implement a Prospective Payment System (PPS) for inpatient rehabilitation under Medicare. This new PPS will be implemented beginning January 1, 2002. This report describes the research that RAND performed to support HCFA's efforts to design, develop, and implement this Inpatient Rehabilitation Facility PPS, or IRF PPS. It presents recommendations concerning the payment system and also discusses our plans for further research on the monitoring and refinement of the PPS. The new PPS will apply to rehabilitation hospitals and to distinct rehabilitation units of acute care hospitals that were excluded from the acute care PPS. Medicare patients in such facilities must receive intensive therapy (generally at least three hours per day). In addition, 75 percent of each facility's patients must have one often specified problems related to neurological or musculoskeletal disorders or burns. Since 1982, Medicare payment for these rehabilitation facilities has been made under the Tax Equity and Fiscal Responsibility Act (TEFRA). The payment amount depends on a per-case target amount that is calculated from historical costs at the facility trended forward and on the hospital's actual cost per case. Under TEFRA, there is no adjustment for changes in a hospital's case mix or for outlier cases. This lack of adjustment creates incentives for providers to specialize in relatively less-expensive cases and, as a result, might limit beneficiary access. TEFRA pays for discharges that do not include a full course of rehabilitation (e.g., short stays for evaluation, transfer cases) as full cases. These payments in excess of costs may have both quality and cost-control implications. TEFRA was widely perceived to be unfair to older hospitals.
Author: Grace M. Carter Publisher: RAND Corporation ISBN: 9780833031488 Category : Health & Fitness Languages : en Pages : 0
Book Description
This report describes the research that Rand performed to support the efforts of the Health Care Financing Adinnistration to design, develop, and implement a Prospective Payment System.
Author: Publisher: ISBN: 9780833056634 Category : Hospitals Languages : en Pages : 338
Book Description
In the Balanced Budget Act of 1997, Congress mandated that Health Care Financing Administration (HCFA) implement a Prospective Payment System (PPS) for inpatient rehabilitation. The Centers for Medicare and Medicaid Services (CMS, the successor agency to HCFA) issued the final rule governing such a PPS on August 7, 2001 and the system went into effect on January 1, 2002. This report details the analyses that RAND performed to support HCFA's efforts to design, develop, and implement the PPS. It describes RAND's research on new function-related groups, comorbidities, unusual cases, facility-level adjustments, outlier payments, facility-level adjustments, and assessment instruments. In addition, it presents RAND's recommendations concerning the payment system and discusses the researchers' plans for further research on the monitoring and refinement of the PPS.
Author: Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
In the Balanced Budget Act of 1997, Congress mandated that the Health Care Financing Administration (HCFA) implement a Prospective Payment System (PPS) for inpatient rehabilitation under Medicare. This new PPS was implemented beginning on January 1, 2002. The Centers for Medicare and Medicaid Services (CMS, the successor agency to HCFA) issued the final rule governing the PPS on August 7, 2001. This report describes the research that RAND performed to support HCFA's efforts to design, develop, and implement this PPS. It presents recommendations concerning the payment system and discusses our plans for further research on the monitoring and refinement of the PPS. The initial design of the system was first presented in a Notice of Proposed Rule Making (NPRM) (HCFA, 2000). Our interim report, Carter et al. (2000), presented analyses that HCFA used to help make its decisions in the NPRM. In this report, we update these analyses using later data. We also improve the analysis and our recommendations to HCFA by taking into account comments made by our Technical Expert Panel in its review of our interim report. This is a report of research. The final decisions made by CMS and the rationale for those decisions may be found in the rule governing the IRF PPS (CMS, 2001). The new PPS applies to rehabilitation hospitals and to distinct rehabilitation units of acute care hospitals, which are excluded from the acute care PPS. To qualify for such exclusion, rehabilitation facilities must meet two conditions. First, Medicare patients must receive intensive therapy (generally at least three hours per day). Second, 75 percent of each facility's patients must have one of 10 specified problems related to neurological or musculoskeletal disorders or burns. We call this PPS the Inpatient Rehabilitation Facility PPS, or IRF PPS.
Author: Rand Corporation Publisher: ISBN: Category : Abstracts Languages : en Pages : 216
Book Description
Includes publications previously listed in the supplements to the Index of selected publications of the Rand Corporation (Oct. 1962-Feb. 1963).
Author: Grace M. Carter
Author: Grace M. Carter
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Author: Grace M. Carter
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Author: Rand Corporation