title: Prospective per diem rates for skilled nursing care.
abstract: On July 1, 1998, Medicare's cost-related reimbursement method for skilled nursing facility care was replaced with a prospective payment system that includes a case-mix adjustment based on the Resource Utilization Groups to which Medicare residents are assigned. Shortly thereafter, Congress modified the new system in response to the industry's complaints about low payment rates. The new system aims to align Medicare payments more closely with the costs facility's incur in serving Medicare residents and slow Medicare spending growth. Recent rate increases have reduced the new system's ability to trim Medicare outlays.
authors.affiliation: State Healthcare Division of Affiliated Computer Services, Inc., Rockville, MD, USA.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Grimaldi
mesh_terms: D000066:Accounting / Q000379:methods; D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D016361:Bankruptcy; D014487:Centers for Medicare and Medicaid Services, U.S.; D003953:Diagnosis-Related Groups / Q000145:classification* / Q000191:economics*; D005376:Financial Management / Q000379:methods*; D019981:Health Care Sector; D006801:Humans; D006278:Medicare / Q000191:economics* / Q000331:legislation & jurisprudence; D009730:Nursing Assessment / Q000191:economics; D011445:Prospective Payment System; D011907:Rate Setting and Review; D012866:Skilled Nursing Facilities / Q000191:economics*; D019467:Subacute Care / Q000145:classification* / Q000191:economics*; D014481:United States