Final Report on Assessment Instruments for a Prospective Payment System
Jan 1, 2004
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These appendices accompany a report that evaluates alternative assessment tools for use in a prospective payment system (PPS) for inpatient rehabilitation facilities. They include samples of study forms and instructions; descriptions of measures; recruitment and participation letters; characteristics of participating facilities; sample study newsletters; and sampling protocols. The PPS was designed for use with the Functional Independence Measure. Policymakers hoped to substitute a new, more comprehensive, multipurpose assessment instrument, the Minimum Data Set-Post-Acute Care (MDS-PAC). This study compares the potential effects of this substitution. The MDS-PAC is a comprehensive data collection tool, with over 300 items, including sociodemographic information, pre-admission history, advance directives, cognitive and communication patterns, mood and behavior patterns, functional status, bladder/bowel management, diagnoses, medical complexities, pain status, oral/nutritional status, procedures/services, functional prognosis, and resources for discharge. To use the MDS-PAC in the new payment system, researchers needed a way to create a FIM-like motor score and a FIM-like cognitive score. A proposed translation was refined and evaluated. The goal of the report was to determine whether the planned substitution of the MDS-PAC for the FIM in the proposed inpatient rehabilitation hospital prospective payment system would adversely affect system performance, patients, or hospitals.
Functional Independence Measure
Minimum Data Set - Post Acute Care
Recruitment and Study Participation Letters
Characteristics of Participating Facilities
Study Forms and Instructions
Sample Study Newsletters
Calibration Team Practice Sites
Calibration Team Sampling Protocol
The research described in this report was sponsoredby the Centers for Medicare and Medicaid Services (formerly the Health Care Financing Administration). The research was conducted through a subcontract from RAND to Harvard University and represents a collaborative effort involving faculty from the department of Health Care Policy at Harvard Medical School, Sargent College of Health and Rehabilitation Sciences at Boston University and RAND Health.
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