Document Information
Possible Refinements to the Facility-Level Payment Adjustments for the Inpatient Rehabilitation Facility Prospective Payment System
The Centers for Medicare and Medicaid Services (CMS) implemented the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) beginning on January 1, 2002. This report describes potential refinements to the facility-level payment adjustments for the IRF PPS. These refinements improve upon current adjustments by utilizing more recent data from CY 2002, more accurate case mix groups (CMGs), and improved statistical methods. Standard linear regression is used to derive the facility payment adjustments. We tested the sensitivity of the potential payment adjustments to the presence of statistical outlier facilities. The results are that payment adjustments for rural facilities and for low-income patients are still appropriate; there is support in the data for an indirect teaching adjustment; and potential payment adjustments are not unduly influenced by statistical outlier facilities.
Free, downloadable PDF file(s) are available below.
RAND makes an electronic version of this document available for free as a public service.
Use Adobe Acrobat Reader version 7.0 or higher for the best experience.
Contents
Chapter One:
Introduction
Chapter Two:
Data Sources
Chapter Three:
Methods: Multivariate Regression Analyses
Chapter Four:
Results
Chapter Five:
Conclusions and Recommendations
The research described in this report was supported by the Centers for Medicare and Medicaid Services and conducted by RAND Health.
This product is part of the RAND Corporation technical report series. RAND technical reports may include research findings on a specific topic that is limited in scope or intended for a narrow audience; present discussions of the methodology employed in research; provide literature reviews, survey instruments, modeling exercises, guidelines for practitioners and research professionals, and supporting documentation; or deliver preliminary findings. All RAND reports undergo rigorous peer review to ensure that they meet high standards for research quality and objectivity.
Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.
The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.
* RAND research is conducted across divisions, centers, and projects; these organizational components are represented in the "Related RAND Divisions" section above.
Top
RAND® is a registered trademark. Copyright © 1994-2008 RAND Corporation. 