Case-Mix Reimbursement for Nursing Homes: Objectives and Achievements
Six state Medicaid programs currently use case-mix reimbursement (CMR) systems to pay nursing homes. Quality of care is not decreased under these payment systems and may actually have increased in some instances, while access for heavy-care Medicaid patients appears to have improved. As for equity o...
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| Veröffentlicht in: | The Milbank quarterly 1989-01, Vol.67 (1), p.103-136 |
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| container_title | The Milbank quarterly |
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| creator | Butler, Patricia A. Schlenker, Robert E. |
| description | Six state Medicaid programs currently use case-mix reimbursement (CMR) systems to pay nursing homes. Quality of care is not decreased under these payment systems and may actually have increased in some instances, while access for heavy-care Medicaid patients appears to have improved. As for equity of payment, CMR methods when compared with others tend to redistribute funds more in accord with resident care needs. Not all of the six states have made cost containment an explicit objective, and program administration costs typically increase. Since CMR systems primarily affect relative payments, however, they can be shaped to achieve total program expenditure objectives. |
| doi_str_mv | 10.2307/3350071 |
| format | Article |
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Since CMR systems primarily affect relative payments, however, they can be shaped to achieve total program expenditure objectives.</description><identifier>ISSN: 0887-378X</identifier><identifier>EISSN: 1468-0009</identifier><identifier>DOI: 10.2307/3350071</identifier><identifier>PMID: 2509875</identifier><identifier>CODEN: MIQUES</identifier><language>eng</language><publisher>United States: Cambridge University Press</publisher><subject>Administrative expenses ; Cost Control ; Cost efficiency ; Cost incentives ; Diagnosis-Related Groups - economics ; Fees & charges ; Health Services Accessibility ; Humans ; Incentive pay ; Medicaid ; Motivation ; Nursing home industry ; Nursing homes ; Nursing Homes - economics ; Nursing Homes - standards ; Payment systems ; Payments ; Quality Assurance, Health Care ; Rate Setting and Review ; Rehabilitation - economics ; Reimbursement ; Reimbursement Mechanisms ; United States</subject><ispartof>The Milbank quarterly, 1989-01, Vol.67 (1), p.103-136</ispartof><rights>Copyright 1989 Milbank Memorial Fund</rights><rights>Copyright Blackwell Publishers Inc. 1989</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-12044a65ccc8fcbe99a3a8773e3be2ea01082d956f23b221b4e5eb385de69c903</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/3350071$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/3350071$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,803,4024,27866,27869,27923,27924,27925,30999,58017,58250</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2509875$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Butler, Patricia A.</creatorcontrib><creatorcontrib>Schlenker, Robert E.</creatorcontrib><title>Case-Mix Reimbursement for Nursing Homes: Objectives and Achievements</title><title>The Milbank quarterly</title><addtitle>Milbank Q</addtitle><description>Six state Medicaid programs currently use case-mix reimbursement (CMR) systems to pay nursing homes. 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Academic</collection><jtitle>The Milbank quarterly</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Butler, Patricia A.</au><au>Schlenker, Robert E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Case-Mix Reimbursement for Nursing Homes: Objectives and Achievements</atitle><jtitle>The Milbank quarterly</jtitle><addtitle>Milbank Q</addtitle><date>1989-01-01</date><risdate>1989</risdate><volume>67</volume><issue>1</issue><spage>103</spage><epage>136</epage><pages>103-136</pages><issn>0887-378X</issn><eissn>1468-0009</eissn><coden>MIQUES</coden><abstract>Six state Medicaid programs currently use case-mix reimbursement (CMR) systems to pay nursing homes. Quality of care is not decreased under these payment systems and may actually have increased in some instances, while access for heavy-care Medicaid patients appears to have improved. As for equity of payment, CMR methods when compared with others tend to redistribute funds more in accord with resident care needs. Not all of the six states have made cost containment an explicit objective, and program administration costs typically increase. Since CMR systems primarily affect relative payments, however, they can be shaped to achieve total program expenditure objectives.</abstract><cop>United States</cop><pub>Cambridge University Press</pub><pmid>2509875</pmid><doi>10.2307/3350071</doi><tpages>34</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0887-378X |
| ispartof | The Milbank quarterly, 1989-01, Vol.67 (1), p.103-136 |
| issn | 0887-378X 1468-0009 |
| language | eng |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; PAIS Index; JSTOR; Periodicals Index Online |
| subjects | Administrative expenses Cost Control Cost efficiency Cost incentives Diagnosis-Related Groups - economics Fees & charges Health Services Accessibility Humans Incentive pay Medicaid Motivation Nursing home industry Nursing homes Nursing Homes - economics Nursing Homes - standards Payment systems Payments Quality Assurance, Health Care Rate Setting and Review Rehabilitation - economics Reimbursement Reimbursement Mechanisms United States |
| title | Case-Mix Reimbursement for Nursing Homes: Objectives and Achievements |
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