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Organizational and market factors associated with Medicare dependence in inpatient rehabilitation hospitals
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2004
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Health AdministrationCost-based ReimbursementHealth Care ManagementMarket FactorsHospital MedicinePrimary CareManagementHealth FinancingInpatient Rehabilitation HospitalsPublic HealthMedicare DependenceHealth Services ResearchBalanced Budget ActHealth PolicyHealth InsuranceOutcomes ResearchHealth ReimbursementRehabilitation HospitalsSingle-payer Health InsuranceHealthcare ValueHealth Care DeliveryNursingHealth EconomicsHealth Care ReimbursementHealth Care CostMedicine
Rehabilitation hospitals in the USA have been excluded from the Medicare Prospective Payment System (PPS) system since 1982, and have received cost-based reimbursement. However, the 1997 Balanced Budget Act mandated a PPS for inpatient rehabilitation, to be implemented by the end of 2002. This study assesses rehabilitation hospitals' dependency on Medicare. Findings show that not-for-profit hospitals, facilities with fewer services, facilities with lower staffing levels, and hospitals with lower operating expenses and profits, have a higher proportion of their inpatient revenue coming from Medicare. These facilities may be vulnerable to the new PPS payment system.