Changes in reimbursement climate: Relationship among outcome, cost, and payor type in the postacute rehabilitation environment

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A number of investigations have been published that examine the efficacy of postacute rehabilitation for patients who have sustained traumatic brain injuries (TBIs). These studies have generally indicated that this level of care is effective in improving overall levels of independence for this patient population. In light of these findings, however, payors and families are requesting justification for perceived high program costs. This retrospective study investigated the outcomes of patients admitted to a postacute TBI rehabilitation facility and analyzed the relationship of these outcomes to the changing economic and reimbursement climate. Results from the study suggest that while costs of patient treatment decreased slightly over the years, greater disability reduction and improvements in living status were achieved by treatment in the latter years of this study. These findings are discussed in relation to previous research with regard to long-term versus short-term cost savings for the catastrophic TBI patient. Differences between payor types for disability reduction and living status, together with differences in program cost and length, were observed. These data suggest an association between rehabilitation effort and outcome.

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