New skilled nursing facility payment scheme boosts Medicare risk.
Medicare's cost-based reimbursement method for skilled nursing facility care has been replaced with a prospective payment system that includes a case-mix adjustment based on resource utilization groups. The changeover will reduce Medicare payments for most skilled nursing facilities. The financial risk of operating these facilities will be far greater if state Medicaid programs that reimburse nursing facilities on a cost basis follow Medicare's lead.
Grimaldi
P L
PL
Birch & Davis Health Management Corporation, Silver Spring, MD, USA.
D003953:Diagnosis-Related Groups / Q000145:classification / Q000191:economics; D006801:Humans; D006278:Medicare / Q000191:economics*; D011445:Prospective Payment System; D011907:Rate Setting and Review; D020414:Risk Sharing, Financial; D012866:Skilled Nursing Facilities / Q000191:economics*; D019467:Subacute Care / Q000145:classification / Q000191:economics; D014481:United States