Inpatient rehabilitation
facilities are a critical venue in the post-acute continuum of care. An
Inpatient Rehabilitation Facility (IRF) provides specialized services
to patients with functional deficits. The facilities are restricted to
treating a patient population of which at least 75% falls into one of
ten diagnostic categories including stroke, amputation, spinal cord injury,
polyarthritis, major multiple trauma, hip fractures, brain injury, congenital
deformity, neurological disorders and burns. Patients usually require
5.5 direct nursing hours per patient per day with an average length of
stay of 10-20 days.
Inpatient rehabilitation facilities are among the few
providers who were originally excluded from the Prospective Payment System
(PPS). However, for cost reporting periods beginning on or after January
1, 2002, an IRF PPS based on patient case mix groups will be phased in
over two cost reporting periods. The new payment system will result in
major changes in the way that IRFs document services and in the way they
are reimbursed.
Murer Consultants, Inc. provides valuable services
to our IRF clients including:
Analyzing the financial impact of the Prospective Payment
System on the Rehabilitation Hospital or Unit including:
- Conducting an analysis of historical patient data
using the case mix groups defined by the PPS in order to determine anticipated
reimbursement.
- Analyzing historical FIM data from UDS to determine
acuity mix applicable to the reimbursement formula.
- Conducting trend analyses to determine impact of
transfer rule on reimbursement.
- Developing financial models estimating reimbursement
by relevant rehabilitation categories impacted by varying percentages
of low income patients treated.
Serving as strategist and facilitator in the re-engineering
of a rehabilitation hospital to position the hospital or unit as a premier
rehabilitation provider.
Identifying means for development of new services and
programs targeted to a patient population with specific functional deficits.
Facilitating interactive work sessions with key medical,
clinical, and administrative staff to identify areas for program and operational
refinement and to identify opportunities for future growth.
Developing a plan of action with recommended strategies
for implementation of identified objectives in order to refine, expand,
and develop rehabilitation markets and services in keeping with need and
opportunity. The plan of action may include:
- Status of program
- Opportunities for growth and expansion
- Financial implications
- Regulatory guidelines and status of compliance
- Managed care environment
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