European journal of physical and rehabilitation medicine
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Eur J Phys Rehabil Med · Jun 2009
Inpatient rehabilitation facilities under the prospective payment system: lessons learned.
For better or for worse, third-party payers are the major drivers of rehabilitation care, and the largest payer for inpatient rehabilitation care in the United States remains the Medicare program. Reimbursement for inpatient rehabilitation facilities (IRF) remained unchanged for many years after the establishment of the program. With the transition of the program to a Prospective Payment System (IRF-PPS), Medicare intermediaries have begun to strictly enforce the new regulations they developed. ⋯ They need to identify and document appropriate rehabilitation diagnoses and comorbidities that will produce the greatest reimbursement. They need to document accurately the admission functional status based upon a 72-hour observation period. Most of all, research needs to demonstrate the types of patients who benefit from IRF admissions.