A federal panel’s recommendation that reimbursement for rehabilitation be the same for inpatient rehabilitation facilities and skilled-nursing facilities is getting immediate pushback from industry stakeholders who say patient care will suffer.
The Medicare Payment Advisory Commission recommended that Congress direct the HHS secretary to eliminate the differences in payments between IRFs and SNFs for selected conditions. It reached this decision after finding overlap in the services provided to patients battling orthopedic, pulmonary and cardiac ailments and infections.
In many of the cases reviewed by MedPAC, the IRF base rates were 49% higher than SNF payments. Creating a site-neutral payment could save Medicare up to $5 billion over five years, according to MedPAC. The panel is also asking Congress that any reductions to IRF payments be phased in over three years.
Industry stakeholders say they are gravely concerned about what will happen if Congress adopts the recommendation. It’s likely that IRFs will stop taking cases for which site-neutral payments are being offered, they contend. As a result, more beneficiaries will end up in a skilled-nursing facility where there is less doctor oversight, more limited access to registered nurses and fewer physical therapy sessions, they argue.
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