PROPS
Prospective Payment System Development for Skilled Nursing Facilities
(SNF Classification Systems)
Funded by: American Health Care Association and National Subacute Care
Association
Subcontract from: Morrison Informatics
Project Period: 11/96 - 7/99
There are three major objectives for this study. First, for stroke and hip
fracture patients we are to model a case-based prospective payment strategy
including both nursing and ancillary costs that may be used in SNFs. To model
this system we will use both the Subacute Care Study and Rehabilitation
Alternative Study data sets, with resources consumed by nursing and ancillary
staff as the cost measure. Second, we will determine whether medical/surgical
patients that require care not included in the RUGS classification system can
be identified in subacute SNFs. We will use the Rehabilitation Alternative
Study sites for this portion of the study and conduct additional chart reviews
seeking information that further characterizes these patients. Once identified,
we will attempt to model payment for these patients based on characteristics
found in the record. Third, prospective data will be collected to validate
and expand these payment strategies to a wide range of medically complex SNF
patients.
Key Staff: Kramer, Eilertsen, Ecord
Research Monographs:
Kramer AM, Eilertsen TB, Ecord MK, Morrison MH. Prospective Payment for Skilled Nursing Facilities: Indicators for Subacute Skilled Nursing Care. UCD Center on Aging Research Section, Denver, Colorado. April 1997.
Kramer AM, Eilertsen TB, Stineman MG, Williams BC, Warren R, Morrison MH. Patient Classification for Per Episode Prospective Payment in Skilled Nursing Facilities. UCD Center on Aging Research Section, Denver, Colorado. June 1997.
Williams BC, Kramer AM, Park PS, Stineman MG, Eilertsen TB, Morrison MH. Patient Classification for Per Episode Prospective Payment in Skilled Nursing Facilities: Feasibility of Defining Per Episode Groups Using the Minimum Data Set (MDS). The University of Michigan Medical Center, Ann Arbor, Michigan. October 1997.
Kramer AM, Eilertsen TB, Ecord MK, Morrison MH. A Prospective Study of New Case-Mix Indices for Subacute Care: Technical Report. Morrison Informatics, Inc., Mechanicsburg, Pennsylvania and UCD Center on Aging Research Section, Denver, Colorado. June 1999.
Kramer AM, Eilertsen TB, Ecord MK, Morrison MH. A Prospective Study of New Case-Mix Indices for Subacute Care: Final Report. Morrison Informatics, Inc., Mechanicsburg, Pennsylvania and UCD Center on Aging Research Section, Denver, Colorado. June 1999.
Policy Presentations:
"Outcomes, Cost, and Payment Approaches for Medicare SNFs and Rehabilitation Hospitals." Health Care Financing Administration. Baltimore, Maryland. February 12, 1997.
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