Creating Needs-Based Tiered Models for Assisted Living Reimbursement

Autor/inn/en	Howell-White, Sandra; Gaboda, Dorothy; Rosato, Nancy Scotto; Lucas, Judith A.
Titel	Creating Needs-Based Tiered Models for Assisted Living Reimbursement
Quelle	In: Gerontologist, 46 (2006) 3, S.334-343 (10 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0016-9013
Schlagwörter	Models; Statistical Analysis; Individual Characteristics; Health Services; Research Methodology; Evaluation Methods; Dementia; Older Adults; Predictor Variables; Health Conditions; Prediction; Regression (Statistics); Sampling; Sample Size; Daily Living Skills; New Jersey + Suchen Sie Ihr Suchwort? Analogiemodell; Statistische Analyse; Personality characteristic; Personality traits; Persönlichkeitsmerkmal; Health service; Gesundheitsdienst; Gesundheitswesen; Research method; Forschungsmethode; Demenz; Älterer Erwachsener; Prädiktor; Vorhersage; Regression; Regressionsanalyse; Alltagsfertigkeit
Abstract	Purpose: This research provides state policy makers and others interested in developing needs-based reimbursement models for Medicaid-funded assisted living with an evaluation of different methodologies that affect the structure and outcomes of these models. Design and Methods: We used assessment data from Medicaid-enrolled assisted living residents and waiver-eligible community-dwelling individuals (N = 726) in order to evaluate five methodologies in the design of these tiered needs-based models. We used ordinary least squares regression analyses in order to evaluate each model's ability to predict the time needed to care for individuals with varying needs (e.g., activities of daily living limitations, dementia, special services.) Results: These models varied in fit from 0.127 to a high of 0.357 using the adjusted R[squared] statistic. Both count and weighted models adequately predicted service needs and discriminated individuals into their appropriate tiers well. Weighted models with the largest score range worked best and provided more flexibility. Implications: Policy makers can tailor the generic tiered models developed with these methods to a state's population. Any state considering adoption of a needs-based tiered model will need to refine its model based on its assisted living population characteristics, its resources, and how the model fits its long-term care system. For the industry, these models can serve to identify levels of care needed in planning for staff time and skill mix required for assisted living as well as other long-term care populations. (Contains 5 tables and 1 figure.) (Author).
Anmerkungen	The Gerontological Society of America. 1030 15th Street NW Suite 250, Washington, DC 20005. Tel: 202-842-1275; Fax: 202-842-1150; e-mail: geron@geron.org; Web site: http://www.geron.org/journals/gsapub.htm.
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10