Dr. Fries' current research in long-term care has three principal components. First, he is one of the primary developers of resident classification systems to measure nursing home case mix -- the intensity or quantity of care provided to individuals. Fries is the originator of the concept of Resource Utilization Groups (RUG-III), a case-mix system for nursing home residents, used for Medicare payments to US nursing homes and Medicaid payments in half of the states. He also helped designed the Medicaid payment systems for New York, Pennsylvania, and most recently, Arkansas. He recently completed work as national task leader in the development of RUG-IV and now is leading a 5-state project to design case-mix allocation systems for states’ home- and community-based care programs.
Second, Fries is a co-designer of the National Minimum Data Set for Nursing Home Residents (MDS), Versions 1 and 2. The MDS is the congressionally mandated for all residents in virtually all US nursing and is incorporated into the current MDS 3.0. In addition to its designed purpose to improve care through care planning, resident-level assessment has applications to the measurement of quality, development of quality norms, and the evaluation of interventions, regulations, and payment incentives. He maintains a database of over 12 million RAI assessments for epidemiological and policy research and a Michigan database linking nursing home and home care data with billing information and vital statistics. Fries is also working with multiple states, including Michigan, Arkansas, Missouri, Maryland, and New Jersey, to rationalize eligibility for long-term care and set long-term care policy.
Third, Fries is the President of interRAI, a 33-nation consortium of researchers using personal-level assessment to improve care of elderly and other vulnerable populations in institutional and non-institutional settings. With interRAI colleagues, Fries has developed assessment systems for nursing homes, home care, palliative care, post-acute care, acute care, assisted living, inpatient and community mental health, intellectual/developmental disabilities, correctional facilities, and children’s mental health. These instruments have already been translated into over a dozen languages and have been adopted as the national instrument for Iceland and New Zealand, multiple Canadian provinces, Hong Kong, Estonia, etc. In the US, 20 states have adopted interRAI instruments. interRAI assessments, along with their applications move towards developing a common language for health and long-term care.
Areas of Interest
Using personal level data to make clinical and policy decision about care of elderly and frail individuals