The effect of prospective payment on rehabilitative care

Dobrez DG, Lo Sasso AT, Heinemann AW. The effect of prospective payment on rehabilitative care. To estimate the difference between cost and prospective payment system (PPS) reimbursements for rehabilitation care and to simulate potential consequences of cost-reducing strategies. A retrospective study to estimate costs and functional status at discharge from care. An academic, urban, rehabilitation hospital. Stroke patients on their first admission to a rehabilitation hospital between 1994 and 1998. Not applicable. Cost was estimated from billing databases. Function was measured using the motor and cognitive components of the FIM instrument. PPS reimbursements were $10,825 (37%) lower than costs. No matter how much therapy was reduced, the costs were still greater than the mean PPS reimbursement. A reduction in length of stay by 9.6 days was required to bring costs in line with the PPS reimbursement, reducing discharge cognitive function by 1.1 points ( P