Nursing home case-mix differences between Medicare and non-Medicare and between hospital-based and freestanding patients.
Case-mix differences between Medicare and non-Medicare nursing home patients and between hospital-based and freestanding nursing home patients were assessed for a sample of 756 patients from 26 nursing homes in six states in 1983. Significant differences were found between Medicare and non-Medicare patients and between hospital-based and freestanding nursing home patients. Thus, two attributes, the percentage of Medicare patient days and whether a nursing home is hospital-based or freestanding, probably should be taken into consideration as facility-level case-mix indicators in determining Medicare reimbursement until a more refined approach to case-mix reimbursement can be developed. Hospital-based/freestanding case-mix differences also suggest that Medicaid reimbursement should recognize potential differences in cost structure between these two types of facilities.
Shaughnessy
P W
PW
Kramer
A M
AM
Schlenker
R E
RE
Polesovsky
M B
MB
D000203:Activities of Daily Living; D000368:Aged; D003365:Costs and Cost Analysis; D003953:Diagnosis-Related Groups; D006801:Humans; D008134:Long-Term Care / Q000145:classification; D006278:Medicare / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000191:economics* / Q000458:organization & administration; D009935:Organizational Affiliation; D011445:Prospective Payment System / Q000191:economics; D011897:Random Allocation; D012046:Rehabilitation; D012866:Skilled Nursing Facilities / Q000191:economics; D014481:United States