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A Case-Mix System for Children and Youth With Developmental Disabilities
Limited funding across health and social service programs presents a challenge regarding how to best match resources to the needs of the population. There is increasing consensus that differences in individual characteristics and care needs should be reflected in variations in service costs, which h...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750751/ https://www.ncbi.nlm.nih.gov/pubmed/33414639 http://dx.doi.org/10.1177/1178632920977899 |
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author | Stewart, Shannon L Celebre, Angela Head, Michael J James, Mary L Martin, Lynn Fries, Brant E |
author_facet | Stewart, Shannon L Celebre, Angela Head, Michael J James, Mary L Martin, Lynn Fries, Brant E |
author_sort | Stewart, Shannon L |
collection | PubMed |
description | Limited funding across health and social service programs presents a challenge regarding how to best match resources to the needs of the population. There is increasing consensus that differences in individual characteristics and care needs should be reflected in variations in service costs, which has led to the development of case-mix systems. The present study sought to develop a new approach to allocate resources among children and youth with intellectual and developmental disabilities (IDD) as part of a system-wide Medicaid payment reform initiative in Arkansas. To develop the system, assessment data collected using the interRAI Child and Youth Mental Health-Developmental Disability instrument was matched to paid service claims. The sample consisted of 346 children and youth with developmental disabilities in the home setting. Using automatic interactions detection, individuals were sorted into unique, clinically relevant groups (ie, based on similar resource use) and a standardized relative measure of the cost of services provided to each group was calculated. The resulting case-mix system has 8 distinct, final groups and explains 30% of the variance in per diem costs. Our analyses indicate that this case-mix classification system could provide the foundation for a future prospective payment system that is centered around stability and equitability in the allocation of limited resources within this vulnerable population. |
format | Online Article Text |
id | pubmed-7750751 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-77507512021-01-06 A Case-Mix System for Children and Youth With Developmental Disabilities Stewart, Shannon L Celebre, Angela Head, Michael J James, Mary L Martin, Lynn Fries, Brant E Health Serv Insights Original Research Limited funding across health and social service programs presents a challenge regarding how to best match resources to the needs of the population. There is increasing consensus that differences in individual characteristics and care needs should be reflected in variations in service costs, which has led to the development of case-mix systems. The present study sought to develop a new approach to allocate resources among children and youth with intellectual and developmental disabilities (IDD) as part of a system-wide Medicaid payment reform initiative in Arkansas. To develop the system, assessment data collected using the interRAI Child and Youth Mental Health-Developmental Disability instrument was matched to paid service claims. The sample consisted of 346 children and youth with developmental disabilities in the home setting. Using automatic interactions detection, individuals were sorted into unique, clinically relevant groups (ie, based on similar resource use) and a standardized relative measure of the cost of services provided to each group was calculated. The resulting case-mix system has 8 distinct, final groups and explains 30% of the variance in per diem costs. Our analyses indicate that this case-mix classification system could provide the foundation for a future prospective payment system that is centered around stability and equitability in the allocation of limited resources within this vulnerable population. SAGE Publications 2020-12-18 /pmc/articles/PMC7750751/ /pubmed/33414639 http://dx.doi.org/10.1177/1178632920977899 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Stewart, Shannon L Celebre, Angela Head, Michael J James, Mary L Martin, Lynn Fries, Brant E A Case-Mix System for Children and Youth With Developmental Disabilities |
title | A Case-Mix System for Children and Youth With Developmental
Disabilities |
title_full | A Case-Mix System for Children and Youth With Developmental
Disabilities |
title_fullStr | A Case-Mix System for Children and Youth With Developmental
Disabilities |
title_full_unstemmed | A Case-Mix System for Children and Youth With Developmental
Disabilities |
title_short | A Case-Mix System for Children and Youth With Developmental
Disabilities |
title_sort | case-mix system for children and youth with developmental
disabilities |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7750751/ https://www.ncbi.nlm.nih.gov/pubmed/33414639 http://dx.doi.org/10.1177/1178632920977899 |
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