Grimaldi Paul L
State Healthcare Division of Affiliated Computer Services, Inc., Rockville, MD, USA.
J Health Care Finance. 2002 Spring;28(3):49-62.
On July 1, 1998, Medicare's cost-related reimbursement method for skilled nursing facility care was replaced with a prospective payment system that includes a case-mix adjustment based on the Resource Utilization Groups to which Medicare residents are assigned. Shortly thereafter, Congress modified the new system in response to the industry's complaints about low payment rates. The new system aims to align Medicare payments more closely with the costs facility's incur in serving Medicare residents and slow Medicare spending growth. Recent rate increases have reduced the new system's ability to trim Medicare outlays.
1998年7月1日，医疗保险针对熟练护理机构护理的成本相关报销方法被一种前瞻性支付系统所取代，该系统包括基于医疗保险居民所归属的资源利用组进行病例组合调整。此后不久，国会针对该行业对低支付率的投诉对新系统进行了修改。新系统旨在使医疗保险支付与机构在为医疗保险居民提供服务时产生的成本更紧密地挂钩，并减缓医疗保险支出的增长。最近的费率上调降低了新系统削减医疗保险支出的能力。
