Study of Patient Classification Systems for Prospective Rate-Setting for Medicare Patients in General Hospital Psychiatric Units and Psychiatric Hospitals. Executive Summary

摘要

The National Institute of Mental Health (NIMH) and the Health Care Financing Administration (HCFA) jointly funded a study to examine the strengths and weaknesses of the various patient classification systems that might be used in bringing such units/hospitals into the Medicare PPS. The Medicare DRG Prospective Payment System was developed using data only from short-stay general hospitals. The NIMH/HCFA study examines the adequacy of various existing and modified patient classification systems for possible use in the Medicare PPS. The study should be of use to insurers, State and local mental health agencies, and researchers interested in examining (1) the effects of various patient classification systems on prospective payment for mental health services and (2) some of the major issues connected with bringing the exempted psychiatric units/hospitals into the Medicare PPS.