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Analysis of Data on High Users of State Psychiatric Hospitals and the Implications for Medicare's 190-Day Lifetime Psychiatric Hospital Limit. Final Report

机译:国家精神病医院高用户数据分析及对医疗保险190天终身精神病医院限额的影响。总结报告

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Using Medicare Cost Report data from FY 1986 and FY 1987, this study evaluated the financial impact of the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) on psychiatric facilities excluded from the Prospective Payment System (PPS); and proposed modifications of the existing TEFRA payment system to improve the fairness of payments and maintain appropriate incentives for cost-effective care. The modifications considered consist of reintroduction of the use of peer groups into the TEFRA payment methodology and of changes in the form of Medicare risk sharing in hospital gains and losses. The report presents the data used for the study of the impact of TEFRA and for study of the proposed modifications; discusses the Medicare Cost Reports; assesses the impact of TEFRA on psychiatric hospitals and qualified psychiatric units of general hospitals; contains an analysis of alternative peer groups to be used in a modified TEFRA system of PPS-excluded psychiatric units of general hospitals; provides the results of gain-and-loss simulations implemented on exempted units and assesses different reimbursement options for psychiatric hospitals.

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