The road to success in PPS: Guiding care for efficiency and effectiveness

Abstract

This article features one organization's attempt to interpret and form operational definitions for the initiation of the prospective payment system (PPS) by October 1, 2000. Data collection, initiated with the October 28, 1999, proposed regulations, showed inconsistent use of resources when patient needs were similar based on the initial 20 indicators used to calculate acuity and payment levels in PPS. A decision to use a clinical guidance system with the potential to control outcomes and use rates resulted in the development of a system called Care Guides. These tools help home care staff develop and implement efficient and effective home care plans.