Prospective payment, prospective challenge.
The Centers for Medicare and Medicaid Services has implemented an inpatient rehabilitation facility prospective payment system ( IRF- PPS) based on case-mix groups (CMGs). The CMGs, now almost identical in structure to the Functional Independence Measure-Function-Related Groups (FIM-FRGs), will measure patients' functional severity by the FIM trade mark instrument, rather than by the Minimum Data Set for Post-Acute Care, as was initially planned. Although this late change in plans is a major triumph for physical medicine and rehabilitation and for the patients we serve, economic incentives inherent in the IRF- PPS may still transform inpatient rehabilitation as it is currently practiced in the United States. This commentary compares the CMGs with the FIM-FRGs; addresses the implications of the CMGs' implementation for patients, researchers, and clinicians; and highlights ways of adapting previous FIM-FRG applications and research to help meet the challenges presented by the new IRF- PPS.[1]References
- Prospective payment, prospective challenge. Stineman, M.G. Archives of physical medicine and rehabilitation. (2002) [Pubmed]
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