Possible Refinements to the Facility-Level Payment Adjustments for the Inpatient Rehabilitation Facility Prospective Payment System

Susan M. Paddock, Grace M. Carter, Barbara O. Wynn, Annie Jie Zhou

ResearchPublished May 20, 2005

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.

Topics

Document Details

Citation

Chicago Manual of Style

Paddock, Susan M., Grace M. Carter, Barbara O. Wynn, and Annie Jie Zhou, Possible Refinements to the Facility-Level Payment Adjustments for the Inpatient Rehabilitation Facility Prospective Payment System. Santa Monica, CA: RAND Corporation, 2005. https://www.rand.org/pubs/technical_reports/TR219.html.
BibTeX RIS

The research described in this report was supported by the Centers for Medicare and Medicaid Services and conducted by RAND Health.

This publication is part of the RAND technical report series. RAND technical reports, products of RAND from 2003 to 2011, presented research findings on a topic limited in scope or intended for a narrow audience; discussions of the methodology employed in research; literature reviews, survey instruments, modeling exercises, guidelines for practitioners and research professionals, and supporting documentation; and preliminary findings. All RAND technical reports were subject to rigorous peer review to ensure high standards for research quality and objectivity.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit www.rand.org/pubs/permissions.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.