Final Report on Assessment Instruments for a Prospective Payment System

R The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors. All rights reserved. No part of this book may be reproduced in any form by any electronic or mechanical means (including photocopying, recording, or information storage and retrieval) without permission in writing from RAND. A profile of RAND Health, abstracts of its publications, and ordering information can be found on the RAND Health home page at www.rand.org/health. Preface The Balanced Budget Act of 1997 mandated the implementation of a prospective payment system for inpatient rehabilitation. The Health Care Financing Administration (now the Centers for Medicare and Medicaid Services) issued a which described the design of the rehabilitation prospective payment system (PPS) and reflected their desire to substitute a new, broader, multipurpose data collection instrument, the Minimum Data Set—Post-Acute Care, for the original Functional Independence Measure. This study assesses the potential implications of making this substitution on patient classification and facility payment. The appendices to this report are published in a separate volume as J. L. and others to support RAND and the Centers for Medicare and Medicaid Services in their efforts to design and implement a prospective payment system for inpatient rehabilitation. The role of each organization is described below. Harvard Medical School had responsibility for the project design, its implementation, analysis, and the preparation of the final report. provided the rehabilitation expertise for the development and preparation of training materials, hired the calibration teams, supervised their training, and conducted the certification process for both the calibration teams and the institutional-based data collection teams. They were responsible for hiring the field core coordinator who oversaw the entire field operation. They also participated in the analytic phase of the project. RAND was the prime contractor providing both overall guidance and some of the analytic support to the project, particularly for the factor analysis. Hebrew Rehabilitation Center for the Aged conducted the train the trainers program on the MDS-PAC and ran a regular MDS-PAC training program for our calibration teams. They also provided expert consultation to the field coordinator and the study team on questions with the MDS-PAC. Uniform Data System for Medical Rehabilitation provided trainers and conducted 10 training sessions across the country on the MDS-PAC for our institutional …