Developing a case-mix model for PPS.
Agencies are pinning hopes for success under PPS on an accurate case-mix adjustor. The Health Care Financing Administration (HCFA) tasked Abt Associates Inc. to develop a system to accurately predict the volume and type of home health services each patient requires, based on his or her characteristics (not the service actually received). HCFA wanted this system to be feasible, clinically logical, and valid and accurate. Authors Goldberg and Delargy explain how Abt approached this daunting task.
Goldberg
H B
HB
Abt Associates Inc, in Cambridge, Massachusetts, USA. henry_goldberg@abtassoc.com
Delargy
D
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D014487:Centers for Medicare and Medicaid Services, U.S.; D003953:Diagnosis-Related Groups / Q000145:classification / Q000191:economics; D006699:Home Care Services / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D006278:Medicare / Q000191:economics; D008962:Models, Theoretical; D011445:Prospective Payment System / Q000191:economics / Q000458:organization & administration*; D012720:Severity of Illness Index; D014481:United States