In case-mix-based payment systems, higher per diem rates are paid for residents requiring what?

In case-mix-based payment systems, higher per diem rates are allocated for residents requiring more services. This approach acknowledges that individuals with more complex medical needs or conditions will necessitate a higher level of care, as they often require additional resources, staff time, and specialized treatments.

The payment system is designed to reflect the intensity of care provided to each resident. When residents have conditions that involve extensive procedures, therapies, or support, the facility incurs higher costs. Therefore, to adequately compensate for these increased demands on services and resources, the payment structure allows for increased per diem rates. As a result, facilities can maintain the quality of care and resources necessary to meet the needs of residents with more serious health issues.

In contrast, residents requiring fewer services would naturally result in lower costs and therefore a lower per diem rate, as their care involves less complexity and fewer resources.