On the Reimbursement Front One of the top concerns on the horizon concerning reimbursement for speech-language pathology services in the Medicare arena is Prospective Payment Systems (PPS) for Nursing Homes and Home Health Agencies. PPSs are already being discussed in Congressional committee meetings. The Health Care Financing Administration (HCFA) has promised implementation for skilled ... Viewpoint
Viewpoint  |   May 01, 1997
On the Reimbursement Front
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Older Adults & Aging / Viewpoint
Viewpoint   |   May 01, 1997
On the Reimbursement Front
SIG 15 Perspectives on Gerontology, May 1997, Vol. 2, 13-14. doi:10.1044/gero2.1.13
SIG 15 Perspectives on Gerontology, May 1997, Vol. 2, 13-14. doi:10.1044/gero2.1.13
One of the top concerns on the horizon concerning reimbursement for speech-language pathology services in the Medicare arena is Prospective Payment Systems (PPS) for Nursing Homes and Home Health Agencies. PPSs are already being discussed in Congressional committee meetings. The Health Care Financing Administration (HCFA) has promised implementation for skilled nursing facilities sometime in 1998. What could this mean to the delivery of rehabilitation services to the geriatric population that need the services in a nursing home or home health setting? The main emphasis of PPS is to reduce cost. This is accomplished by paying the nursing home or home health agency a given dollar amount in advance to provide for the total care of a client. Total care would include room, board, medicine, nursing care, laboratory services, x-ray, durable medical equipment, enteral feedings, respiratory therapy, physical therapy, occupational therapy, and speech-language pathology. This rate would be based on past historical data that may or may not take into account the true cost of the services listed above. Another HCFA proposal bases payments on the Minimum Data Set resident assessment. If a nursing home or home health care agency is to break even or make a profit, it will have to control costs whenever and wherever possible. If faced with paying for nursing or paying for speech-language pathology services, who do you think will be restricted from the care of the patient? Speech-language pathology, as well as occupational therapy, and physical therapy are necessary components in the care of the geriatric patient. We may be looking at these services becoming a luxury item, instead of a required aspect of quality care and the helpful hand to the client’s recovery.
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