Challenges in bringing exempt psychiatric services under a prospective payment system.

Area of Science:

• Health policy and administration
• Psychiatric services reimbursement

Background:

• Psychiatric programs are currently exempt from Medicare's prospective payment system.
• A report is due to Congress by December 31, 1985, on integrating these programs.
• The core issue involves equitable fund allocation for psychiatric treatment across facilities.

Purpose of the Study:

• To evaluate the feasibility of including psychiatric services under Medicare's prospective payment system.
• To propose methods for classifying and improving payment systems for psychiatric care.
• To identify strategies for a smooth transition to a prospective payment model.

Main Methods:

• Review of current Medicare prospective payment system criteria and methods.
• Analysis of advantages for incorporating psychiatric services.
• Identification of areas needing further research for system integration.

Main Results:

• Discussion of the benefits of integrating psychiatric services into the prospective payment system.
• Presentation of criteria and methods for evaluating a psychiatric prospective payment system.
• Suggestions for enhancing current classification and payment structures.

Conclusions:

• Psychiatric programs can potentially be integrated into Medicare's prospective payment system.
• Improvements to classification and payment systems are necessary for successful integration.
• Further research is required to address remaining challenges and ensure a smooth transition.