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Throughout the 1970s and into the early 1980s continuing efforts to control inflation in Medicaid expenditures led states to adopt stricter Medicaid eligibility standards, which in combination with a recession in the early 1980s left nearly 40 percent of the nation's poor without medical coverage. To prevent further restrictions in Medicaid access, the Robert Wood Johnson Foundation (RWJ) sponsored a demonstration project, the Program for Prepaid Managed Health Care (PPMHC) in the first half of the 1980s. This RAND Corporation report contains the design and results from the cost and utilization evaluation of the PPMHC.

Health insurance --- Capitation fees (Medical care) --- Preferred provider organizations (Medical care)

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The overall growth of Medicare Part B charges for rehabilitation services is high and if unabated, will exacerbate Medicare's cost containment problem. Regression models show that the pattern of therapy used, the use of multiple providers, and patient characteristics and diagnostic categories all have an impact on charges. However, even controlling for all other factors, independent rehabilitation agencies consistently had the highest charges across all models, and hospital outpatient departments the lowest. Thus, if rehabilitation services are included in Medicare's projected new payment reform, Ambulatory Payment Groups, and if the reform covers only hospital outpatient departments, it would encourage a shift to more expensive providers.

Hospitals --- Rehabilitation services. --- Outpatient services.

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Nursing homes --- Nurse practitioners. --- Geriatric nursing. --- Nursing home care. --- Finance.

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In the Balanced Budget Act of 1997, Congress mandated that Health CareFinancing Administration (HCFA) implement a Prospective Payment System (PPS)for inpatient rehabilitation. The Centers for Medicare and Medicaid Services(CMS, the successor agency to HCFA) issued the final rule governing such aPPS on August 7, 2001.

Hospitals. --- Hospitals --- Inpatients --- Rehabilitation Centers --- Prospective Payment System --- Patients --- Health Facilities --- Reimbursement Mechanisms --- Persons --- Health Care Facilities, Manpower, and Services --- Insurance, Health, Reimbursement --- Health Care --- Financing, Organized --- Names. --- Economics --- Health Care Economics and Organizations --- Prospective payment --- Rehabilitation services