Cohen J, Holahan J
Inquiry. 1986 Spring;23(1):23-39.
One of the more controversial issues in reimbursement policy is how to set the capital cost component of facilities rates. In this article we examine in detail the various approaches used by states to reimburse nursing homes for capital costs. We conclude that newer approaches that recognize the increasing value of nursing home assets over time, commonly called fair rental systems, are preferable to the methodologies that have been used historically in both the Medicare and the Medicaid programs to set capital rates. When properly designed, fair rental systems should provide more rational incentives and less encouragement of property manipulation than do more traditional systems, with little or no increase in state costs.
报销政策中争议较大的问题之一是如何设定机构费率中的资本成本部分。在本文中，我们详细研究了各州用于报销养老院资本成本的各种方法。我们得出的结论是，承认养老院资产价值随时间不断增加的新方法，通常称为公平租赁系统，比医疗保险和医疗补助计划历史上用于设定资本费率的方法更可取。如果设计得当，公平租赁系统应比传统系统提供更合理的激励措施，减少对房产操纵的鼓励，而州成本几乎不会增加或根本不会增加。
