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Reimbursement of ICFs/MR program costs based on client resource use
R Chapin1, L Rotegard, B B Manard
1School of Social Welfare, University of Kansas, Lawrence 66045-2510.
Mental Retardation
|October 1, 1991
Summary
A new reimbursement system for Intermediate Care Facilities for the Mentally Retarded (ICFs/MR) in Minnesota is proposed, based on individual client resource use. This approach accounts for significant variations in care needs and facility costs for better resource allocation.
Area of Science:
- Health Services Research
- Healthcare Economics
- Disability Services
Background:
- Current reimbursement systems for Intermediate Care Facilities for the Mentally Retarded (ICFs/MR) may not accurately reflect varying client needs.
- A need exists for a more targeted and equitable reimbursement strategy.
Purpose of the Study:
- To propose and evaluate a new reimbursement system for ICFs/MR in Minnesota.
- To base program rates on individual client resource use.
Main Methods:
- A stratified sample of 913 residents across 65 ICFs/MR in Minnesota was assessed.
- Staff resource use was determined based on client characteristics and facility data.
Main Results:
- Client factors such as personal interaction, independence, daily living activities, medical complexity, and behavior significantly predicted resource use.
- A substantial amount of variation in resource use remained unexplained, supporting an individualized approach.
Conclusions:
- Recommends a reimbursement system that bases program rates on individual client resource use.
- Advocates for incorporating historical facility costs into the new reimbursement model.
- Highlights key design considerations for implementing such a system.