Health syst manage 1985171 312 setting rates for hospital and nursing home care grimaldi pl pmid 10313478 pubmed indexed for medline mesh terms cost control methods diagnosis related groups economics economic competition economics hospital health expenditures medicare models theoretical nursing homes economics rate setting and review methods united states . Additional physical format online version grimaldi paul l setting rates for hospital and nursing home care new york sp medical scientific books c1985. Individual at home care may be provided for no more than five consecutive days for purposes of the definition home does not include a nursing facility 38 hospital leave day means any day that a resident is not in the facility but is in an acute care setting as an inpatient or has been identified in a resident assessment instrument. Rates may be set per service or per case eg hospital care for a heart attack rate setting has mainly been used for hospital inpatient and outpatient services under a system of all payer rates the reimbursement a provider receives for a given service is the same regardless of who pays different payers would not pay different rates for the same service as is the case today currently . This analysis compares nursing home costs medicaid payment rates and profits under three medicaid nursing home payment systems case mix facility specific and class rate systems data used were collected from 135 nursing homes in seven states the association of case mix with costs rates and profits under the three payment systems was of particular interest case mix was more strongly
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