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Early Effects of the Prospective Payment System on Inpatient Rehabilitation Hospital Performance
- Source :
- Archives of Physical Medicine and Rehabilitation. 87:198-202
- Publication Year :
- 2006
- Publisher :
- Elsevier BV, 2006.
-
Abstract
- McCue MJ, Thompson JM. Early effects of the prospective payment system on inpatient rehabilitation hospital performance. Objective To assess changes in utilization and financial performance for inpatient rehabilitation facilities (IRFs) that shifted from Medicare's cost-based payment system to the IRF prospective payment system (PPS). Design A pre-post nonequivalent comparison group design. The intervention group included IRFs that changed to the PPS in fiscal year 2002. The comparison group included IRFs that were paid under the cost-based system. Setting IRFs in the United States. Participants Final sample included 120 IRFs, with 26 IRFs in the comparison sample. Interventions Not applicable. Main Outcome Measures Outcome measures included utilization (length of stay [LOS], total discharges, Medicare discharges) and financial performance (revenue, expenses, profitability, Medicare payment and cost). Results PPS IRFs experienced a smaller decline in LOS, whereas Medicare cost per discharge increased at a lower rate. PPS IRFs reduced operating costs per discharge, whereas profit margin had a greater increase. Conclusions IRFs under PPS implemented cost controls that lead to lower operating costs below the fixed payment to profit under PPS. Discharge growth for PPS IRFs was similar to the comparison group. PPS facilities did not implement a strategy that attempted to admit more patients to increase Medicare payments.
- Subjects :
- Gerontology
medicine.medical_specialty
media_common.quotation_subject
medicine.medical_treatment
education
Payment system
Physical Therapy, Sports Therapy and Rehabilitation
Medicare
Rehabilitation Centers
Fiscal year
Profit margin
Humans
Medicine
Revenue
health care economics and organizations
Operating cost
media_common
Inpatients
Rehabilitation
Prospective Payment System
business.industry
Length of Stay
Financial Management, Hospital
Payment
Emergency medicine
Costs and Cost Analysis
Prospective payment system
business
Subjects
Details
- ISSN :
- 00039993
- Volume :
- 87
- Database :
- OpenAIRE
- Journal :
- Archives of Physical Medicine and Rehabilitation
- Accession number :
- edsair.doi.dedup.....2b469a2ab089c4a709e9a55b5b3a6f7c