Nursing Homes and Rehab Hospitals Square off over Payments

Roll Call, July 21, 2014 | Go to article overview

Nursing Homes and Rehab Hospitals Square off over Payments


Medicare patients who need rehabilitation after a hospital stay can get their care from several types of medical providers. Depending on their medical needs and other factors, they may be able to get treatment from a specialized rehab hospital, at home with help from home health care aides or outpatient therapists, or in a nursing facility.

But the cost of care for each kind of treatment is starkly different, and the decision about where patients should get their treatment has implications for the federal health care budget and for the growing number of Americans who depend on Medicare for their health care coverage.

Currently, Medicare pays more for the care at rehab hospitals than it does at nursing facilities. However, the Medicare Payment Advisory Commission, the panel known as MedPAC that gives lawmakers guidance on Medicare policies, said in a report this year that at least for some conditions, the higher payments may not always be justified.

The MedPAC report and the recent introduction of a bill in Congress by top Republicans and Democrats reinvigorated a little- noticed but intensely-lobbied debate over how Medicare should pay for patients who need therapy after hospitalization.

Particularly for orthopedic conditions such as hip fractures or major joint replacements, patients who get care from inpatient rehab hospitals had similar traits and outcomes as those who were treated in a skilled nursing home, according to the MedPAC study published in June. Given those similarities, the commission asked, why should Medicare pay more for patients in rehab hospitals than in nursing facilities?

The commission also looked at stroke patients, but in those cases the panel found there were greater differences between the patients treated in the two different settings. Skilled nursing homes often take care of stroke patients who have a history of falling or have trouble sitting without help, while inpatient rehabilitation hospitals typically care for more people who have trouble controlling their facial motions, like swallowing.

MedPAC is not alone in proposing changes that would bring the prices for rehab hospitals and for skilled nursing homes closer together. Since 2007, both the Bush and the Obama administrations suggested reducing the price differences for patients with some conditions.

Lawmakers also are discussing ways to judge, in a standardized way, the effectiveness of different methods of providing care to patients after they leave a hospital. In one of the rare signs of bipartisan, bicameral cooperation on health care issues this year, the Democratic and Republican leaders of the House Ways and Means and Senate Finance committees introduced a bill in late June that would create a uniform way of measuring the care that home health aides, rehab therapists and nursing home staff members provide to people after a hospital stay.

Although the legislation (HR 4994) is not expected to become law soon, it sets the stage for a deeper debate later. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Nursing Homes and Rehab Hospitals Square off over Payments
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.