Research Report Options for Improving Medicare Payment for Skilled Nursing Facilities
Korbin Liu, Bowen Garrett, Doug Wissoker, Stephanie Maxwell, Andrew Kramer, Theresa Eilertsen, Anne Epstein, Yu-Chu Shen, Sung-Joon Min, Sharon K. Long, Robert Schlenker, Brant Fries, Joan Buchanan
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Medicare has paid skilled nursing facilities (SNFs) using a prospective payment system (PPS) since 1998. This report offers policy options to refine Medicares payment of SNF services by developing alternative patient classification models. Three models classify patients according to expected non-therapy ancillary (NTA) costs: two models use data from the SNF to model NTA costs; a third adds data from prior hospital stays. A fourth model predicts rehabilitation therapy costs using patient characteristics. The fifth uses Diagnostic Related Groups to predict total SNF care costs. The report also simulates options for outlier payments for exceptionally high-cost cases.
Research Areas Health and health care
Tags Health care laws and regulations
Policy Centers Health Policy Center