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Related Experiment Videos

Does payment structure influence change in physical functioning after rehabilitation therapy?

George R Shannon1, Judy Y Yip, Kathleen H Wilber

  • 1Andrus Gerontology Center, University of Southern California, Los Angeles, CA 90028-0191, USA. gshannon@usc.edu

Home Health Care Services Quarterly
|May 19, 2004
PubMed
Summary

Medicare managed care (MCO) and fee-for-service (FFS) payment structures did not impact geriatric rehabilitation therapy intensity or physical functioning outcomes. Both groups showed similar improvements in physical function post-therapy.

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Area of Science:

  • Geriatric Rehabilitation
  • Health Services Research
  • Physical Therapy Outcomes

Background:

  • Payment structures in healthcare, including Medicare managed care (MCO) and fee-for-service (FFS), can influence healthcare delivery and patient outcomes.
  • Geriatric rehabilitation is crucial for restoring function and independence in older adults.

Purpose of the Study:

  • To compare the duration and intensity of geriatric rehabilitation therapy between MCO and FFS payment structures.
  • To assess the effect of payment structure on changes in physical functioning at discharge.

Main Methods:

  • A study involving 100 patients (68 MCO, 32 FFS) from three skilled nursing facilities in Southern California.
  • Physical functioning was measured using the Sickness Impact Profile (SIP-PFD) before and after rehabilitation.

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  • Statistical analyses included chi-square, t-tests, logistic regression, and ordinary least squares (OLS) regression.

    • Main Results:

    • No significant differences were found in patient characteristics at admission based on payment structure.
    • Fee-for-service (FFS) patients received significantly more daily therapy minutes (intensity) compared to Medicare managed care (MCO) patients.
    • All patients demonstrated significant improvements in physical functioning from admission to discharge, with no significant difference between MCO and FFS groups.

    Conclusions:

    • Payment structure did not significantly affect the change in physical functioning at discharge for geriatric rehabilitation patients.
    • Future research with larger sample sizes is recommended to explore other factors influencing therapy and outcomes.