Washington Report…. Section for Long Term Care and Rehabilitation Dallas, Texas February 27-28, 2001. Brian Ellsworth and Barbara Marone Senior Associate Directors American Hospital Association.
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Section for Long Term Care and Rehabilitation
February 27-28, 2001
Brian Ellsworth and Barbara Marone
Senior Associate Directors
American Hospital Association
Summary of MedPAC’sView of Post-Acute CareDraft Chapter 6 of the March 1, 2001 Report to Congress:”Post-Acute Care Prospective Payment: Current Issues and Longer Term Agenda”
~ Different conditions of participation
~ Differences in Medicare coverage criteria
AHA recommends that HCFA use FIM
MedPAC recommends:Until a core set of common data elements for post-acute care is developed, the Secretary should require the Functional Independence Measure as the patient assessment tool for the inpatient rehabilitation PPS
Short staytransfers(paid as per diem)
Patients with short stay twice as likely to have comorbidities as others.
Inadequate recognition of the effect of multiple comorbiditieson per diemroutine costs.
Facility costs are estimated using routine charges, which do not vary enough by CMG.
Case weight compression
Routine costs do not vary enough by CMG.
Systematic under-reimbursement for inpatient rehabilitation facilities with a high proportion of patients with multiple comorbidities.
MedPAC recommendation:Secretary should re-examine the disproportionate share adjustment for the inpatient rehabilitation prospective payment system