Stineman M G
Department of Rehabilitation Medicine, Leonard Davis Institute of Health Economics, and Clinical Epidemiology Unit of the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.
Arch Phys Med Rehabil. 2001 Apr;82(4):553-7. doi: 10.1053/apmr.2001.24088.
In November 2000, the Health Care Financing Administration (HCFA) published a proposed rule announcing their intention to implement a prospective payment system for rehabilitation inpatient facilities and hospital units. In this system, payments are to be scaled to patient complexity through a classification system referred to as case-mix groups (CMGs) modeled after the Functional Independence Measure-Function Related Groups, which were developed from the FIM instrument. Under the HCFA proposal, CMGs will be derived from the Minimum Data Set for Post-Acute Care (MDS-PAC). This shift to the MDS-PAC, with little scientific evidence to support it, can have a negative impact on how the system expresses patient need, on how patients access services, and on the equity of hospital payments.
