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Related Experiment Videos

Creating needs-based tiered models for assisted living reimbursement.

Sandra Howell-White1, Dorothy Gaboda, Nancy Scotto Rosato

  • 1Rutgers Center for State Health Policy, 317 George Street, Suite 400, New Brunswick, NJ 08901, USA. showell@ifh.rutgers.edu

The Gerontologist
|May 30, 2006
PubMed
Summary

This study evaluated needs-based reimbursement models for Medicaid-assisted living, finding weighted models best predict care needs and resident needs. States can adapt these tiered models for better resource allocation.

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Area of Science:

  • Health Services Research
  • Gerontology
  • Public Health Policy

Background:

  • Medicaid reimbursement for assisted living is complex.
  • Developing equitable and effective needs-based models is crucial for resource allocation.
  • Existing models may not accurately reflect diverse resident care requirements.

Purpose of the Study:

  • To evaluate methodologies for designing needs-based reimbursement models for Medicaid-funded assisted living.
  • To assess the impact of different model structures on predicting care needs and resident classification.
  • To provide evidence for state policymakers developing tiered reimbursement systems.

Main Methods:

  • Utilized assessment data from 726 Medicaid-enrolled assisted living residents and community-dwelling individuals.

Related Experiment Videos

  • Evaluated five distinct methodologies for tiered, needs-based model design.
  • Employed ordinary least squares regression to predict care time based on individual needs (e.g., ADL limitations, dementia).

    • Main Results:

    • Model fit varied, with adjusted R2 statistics ranging from .127 to .357.
    • Both count and weighted models effectively predicted service needs and tiered residents appropriately.
    • Weighted models with broader score ranges demonstrated superior performance and flexibility.

    Conclusions:

    • State policymakers can adapt generic tiered models to specific populations, resources, and long-term care systems.
    • The models assist the assisted living industry in planning for staffing, time, and skill mix.
    • Refinement based on state-specific characteristics is essential for successful adoption of needs-based tiered models.