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Written by: Darlene D'Altorio-Jones (1959-2015) on Monday, April 2, 2012 Posted in: Inpatient Rehab

Do we believe we can hold all costs neutral (clothing, housing, education, salaries) to a freeze for the next 10 years? Payment for healthcare is hedging on the reality there is no other way to remain solvent except to adopt that stance. Get ready, the freeze is about to begin; not that we haven’t felt it pretty significantly in IRF/IRU rehabilitation already.

The thought of budget neutral payment in an aging society until 2021 is unfounded, as proposed in ”The President’s Economic Plan and Budget Reduction Proposal.” Redeployment of resources and tightly managed waste is something everyone must hold one another accountable to. Defining and delivering the highest quality at the least and most economical costs is the value every leader must strive toward achieving. It will have to be done, but can we achieve this ideal for the next 10 years?

Inpatient rehabilitation has demonstrated fiscal responsibility per the 2010 MedPac Report. There is evidence that all other post acute care service lines have shown a rise in spending whereas IRF care has a decreasing slope and excellent outcomes. Why not let us provide care to all those that require a multidisciplinary plan in the most efficient effective ways we have developed?


Reward where reward is due and hold level standard performers. If you pay for performance as all indicators say we should, then using today’s dollars as a distribution of outcome warranted payment may go far in ending an across-the-board freeze. Maybe redistribution is the best plan on the horizon. Let outcomes guide those answers.

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