A preliminary case-mix classification system for Medicare home health clients.
In this study, a hierarchical case-mix model was developed for grouping Medicare home health beneficiaries homogeneously, based on the allowed charges for their home care. Based on information from a two-page form from 2,830 clients from ten states and using the classification and regression trees method, a four-component model was developed that yielded 11 case-mix groups and explained 22% of the variance for the test sample of 1,929 clients. The four components are rehabilitation, special care, skilled-nurse monitoring, and paralysis; each are categorized as present or absent. The range of mean-allowed charges for the 11 groups in the total sample was $473 to $2,562 with a mean of $847. Of the six groups with mean charges above $1,000, none exceeded 5.2% of clients; thus, the high-cost groups are relatively rare.
Branch
L G
LG
Abt Associates Inc., Cambridge, MA 02138-1168.
Goldberg
H B
HB
D000368:Aged; D000465:Algorithms; D003953:Diagnosis-Related Groups / Q000191:economics*; D005249:Fees and Charges; D005260:Female; D006699:Home Care Services / Q000145:classification / Q000191:economics*; D006801:Humans; D008134:Long-Term Care / Q000145:classification* / Q000191:economics; D008297:Male; D006278:Medicare / Q000458:organization & administration*; D009739:Nursing Services / Q000145:classification / Q000191:economics; D010243:Paralysis / Q000191:economics / Q000628:therapy; D011445:Prospective Payment System / Q000191:economics*; D012046:Rehabilitation / Q000191:economics; D014481:United States