Incentives in case-mix measures

Helen L. Smits Several States now use patient-based payments for skilled nursing facilities and intermediate care facil-ities; others are in the process of developing case-mix systems. The Health Care Financing Administration is working under congressional mandate to develop a prospective case-mix system for Medicare payments to skilled nursing facilities. If new payment methods fol-low the existing pattern, they will be based not on the Overview Government pricing of nursing home care appears to be undergoing a major change. Traditional methods, which offer an individual facility a single rate for all patients, have been widely criticized for making the heaviest care patients economicall