Reimbursement systems powerfully influence the behavior of nursing home operators. Traditional "case-mix" payment systems create major disadvantages for those homes that provide resident-centered care. Seeking to align payment with performance, the Minnesota legislature is considering enactment of a new payment system that would reward high-quality, high-efficiency providers. This project will develop models to help nursing homes and legislators estimate the financial benefits and costs of operating under the proposed system. The investigators will also describe the current relationship between quality and cost among different types of Minnesota nursing homes. Together, these analyses will help Minnesota's legislature assess the merits of establishing a pay-for-performance system. http://www1.umn.edu