Comparison of Medicaid nursing home payment systems

This article summarizes the main findings of a study comparing three generic Medicaid nursing home payment systems: case-mix, facility-specific, and class-rate. The major comparative analyses examined patient-level case mix and quality, facility-level costs, Medicaid payment rates, and profitability. The study also analyzed case-mix payment systems in greater detail, emphasizing the earlier systems. The results suggest advantages and disadvantages for all system types and highlight important considerations for policyplanners, particularly in States considering case-mix systems. The article concludes with a discussion of issues important to further research on nursing home payment.