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Developing a case-mix model for PPS
1Abt Associates Inc, in Cambridge, Massachusetts, USA. henry_goldberg@abtassoc.com
Caring : National Association for Home Care Magazine
|May 2, 2000
Summary
Accurate case-mix adjustors are crucial for the success of prospective payment systems (PPS). This study details the development of a system to predict home health service needs based on patient characteristics.
Area of Science:
- Health Services Research
- Health Economics
Background:
- Prospective Payment Systems (PPS) rely on accurate case-mix adjustors for success.
- The Health Care Financing Administration (HCFA) sought a reliable method to predict home health service utilization.
Purpose of the Study:
- To develop and validate a system for predicting home health service volume and type.
- To ensure the system is feasible, clinically logical, valid, and accurate.
Main Methods:
- Abt Associates Inc. was tasked with developing the predictive system.
- The system focuses on patient characteristics to forecast service needs, not services received.
Main Results:
- The abstract does not contain specific results, but outlines the approach to developing a predictive model.
- Focus on patient characteristics aims for a clinically logical and accurate prediction.
Conclusions:
- The development of an accurate case-mix adjustor is critical for effective PPS implementation in home health.
- The described approach by Abt Associates Inc. addresses key requirements for a valid and feasible system.