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Related Experiment Videos

The prospective payment system: implications for therapeutic recreation.

R H Olsson

    Therapeutic Recreation Journal
    |December 11, 1985
    PubMed
    Summary

    Medicare

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    Area of Science:

    • Healthcare policy
    • Rehabilitation services
    • Health economics

    Background:

    • Medicare initiated a prospective payment system (PPS) for general hospitals in 1983.
    • Diagnostically-related groupings (DRGs) form the basis of this Medicare PPS.
    • Most therapeutic recreation settings were exempt from the initial DRG-based PPS.

    Purpose of the Study:

    • To review the history of the Medicare program and the rationale for DRG implementation.
    • To analyze the implications of integrating therapeutic recreation settings into the Medicare PPS.
    • To propose strategies for therapeutic recreation professionals in response to upcoming policy changes.

    Main Methods:

    • Historical review of Medicare payment systems.
    • Analysis of the DRG framework and its application.
    • Examination of potential impacts on therapeutic recreation services.

    Main Results:

    • Medicare's DRG-based PPS significantly altered hospital reimbursement structures.
    • Exemptions for therapeutic recreation settings created disparities in payment.
    • A 1985 decision was anticipated regarding the integration of these settings into the PPS.

    Conclusions:

    • Understanding Medicare's DRG system is crucial for therapeutic recreation.
    • Proactive strategies are needed to adapt to evolving healthcare payment policies.
    • Integration into the DRG system presents both challenges and opportunities for therapeutic recreation.

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