The Prospective Payment System

Paper Summary:

This paper explains that the prospective payment system has been used to offset the cost of care and to alleviate the complications faced by those who enter the nursing homes. The author points out that the prospective payment system has undergone criticism and scrutiny since its inception, but is still considered the most viable plan for the financial responsibility of those entering nursing homes. The paper states that the foundational objective of the prospective payment system is to reduce the rates of increase when it comes to Medicare inpatient payments.

From the Paper:

"The Prospective Payment System has changed the way the practice admissions in 70 percent of the nursing homes across the nation. According to nursing home administrators the patient's medical history is scrutinized at a much more close range than they were before the implementation of the Prospective Payment System. "Most administrators state that they scrutinize patients" medical status to a greater extent than they did prior to the implementation of the prospective payment system. Medical condition has become more important in nursing home admissions decisions. Seventy-four percent of nursing home administrators report that a patient's medical condition has become a more important factor in admissions decisions under the new reimbursement system.""

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