Have You Been Injured? We're Ready to Fight for You.

Debate over Rehab for Medicare patients

Published on Aug 25, 2014 at 8:06 am in Accounting Malpractice.

Medicare FundingA debate is brewing on Capitol Hill over the treatment of Medicare patients who need rehab after a hospital stay. Typically, these patients can be treated at several types of facilities – but the government is taking an interest because the costs vary greatly.

If a patient leaves the hospital needing rehabilitation, it can typically be administered from a variety of facilities, depending on the injury. They include:

  • specialized rehab hospitals,
  • a skilled nursing facility,
  • outpatient therapists, or
  • in home health care aides.

The current debate is over the fact that the cost for rehab hospitals are much higher than the costs for treatment at skilled nursing facilities. This issue re-surfaced in June, after a report was released from MedPAC – the Medicare Payment Advisory Commission.

Roll Call, the privately-owned Congressional news site, called attention to the disparities noted in the MedPAC June report to Congress:

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 debate now is over a push to so-called “site-neutral” Medicare payments, where Medicare could decide to pay the two types of facilities – rehab hospitals and skilled nursing facilities — the same for the same treatment, regardless of what they’re charging.

Orthopedic conditions provide one illustration of the disparity. The MedPAC study found that patients with hip fractures or major joint replacements had similar traits and outcomes whether they were admitted to inpatient rehab hospitals or skilled nursing home, although Medicare pays more for rehab hospitals than the nursing facilities.

Not surprisingly, Congress is being heavily lobbied by representatives from both rehab hospitals and nursing facilities. Rehab hospitals defended their higher rates, although the study they used was funded by their own industry. Nursing facilities, on the other hand, are asking for the justification in paying them less than rehab hospitals if the care is similar.

The nursing home industry acknowledged some serious cases that would be better treated at rehab hospitals. But they pointed out that more studies will probably show that for many conditions, nursing homes can provide similar outcomes.

The MedPAC report stated: “[The commission] recognizes that the services in the two settings differ; however, we question whether the program should pay for these differences when the patients admitted and the outcomes they achieve are similar.”

Meet Your Team

Tad Thomas - Trial Lawyer

Tad Thomas

Managing Partner

Tad Thomas has dedicated his practice to representing plaintiffs in various types of civil litigation, including personal injury, business litigation, class actions, and multi-district litigation.

After graduating with his law degree in 2000 from Salmon P. Chase College of Law at Northern Kentucky University, Mr. Thomas immediately opened his own private practice and began representing injury victims.

In 2011, Thomas Law Offices was established in Louisville, Kentucky. Over the past decade, Mr. Thomas has expanded his firm and now has offices in three additional locations: Cincinnati, Ohio, Columbia, Missouri, and Chicago, Illinois. He is also a frequent lecturer on topics like trial skills and ethics and technology.

Free Case Evaluation

At Thomas Law Offices, our personal injury attorneys recognize that our potential clients are likely going through some of the most difficult times of their lives. We don't want you to have to worry about paying out-of-pocket for legal advice when you're just starting to learn your legal rights and options. That's why we provide free case evaluations. We'll offer our expert advice about your potential case and walk you through how we can help you.

Call us or fill out the form below to tell us about your potential case and a personal injury lawyer will get back to you as quickly as possible.

Legal & Firm News

What You Need to Know About Business Litigation and Contingency Fees

If your business has ever been involved in a legal matter, you may be surprised to hear the two phrases together: business litigation and contingency fees. Traditionally, it has been more common to associate a contingency fee model with personal injury law involving individual parties rather than businesses. But this is no longer always the […]

Read More

Signs of PTSD in Military Service Members

It’s estimated that up to one-third of military service members suffer from PTSD. PTSD, post-traumatic stress disorder, is a mental health condition that can develop following a traumatic event. This usually means an event involving actual or threatened death, serious injury, or abuse. People who have seen combat, witnessed death, or experienced a life-threatening situation […]

Read More

AAA Conducts Study Examining Travel Before and During COVID-19

In 2021, new research from the AAA Foundation for Traffic Safety’s New American Driving Survey revealed shifts in driving, traveling, and commuting patterns in the United States. The statistics gathered between July 2019 and December 2020 cannot be analyzed without consideration of COVID-19’s unignorable impact on the numbers—numbers showing marked differences from previous years’ findings.

Read More