Inpatient Rehabilitation Facility Ownership Type Yields Mixed Performances on Quality Measures

Area of Science:

• Health Services Research
• Quality Improvement in Healthcare
• Rehabilitation Medicine

Background:

• Understanding variations in healthcare quality is crucial for patient outcomes.
• Inpatient Rehabilitation Facility (IRF) ownership type (for-profit vs. nonprofit) may influence performance on quality measures.
• The IRF Quality Reporting Program (IRF-QRP) aims to standardize and improve care quality.

Purpose of the Study:

• To evaluate the impact of IRF ownership type on performance across 15 IRF-Quality Reporting Program (IRF-QRP) measures.
• To identify specific quality domains where for-profit and nonprofit IRFs differ.

Main Methods:

• A cross-sectional, observational study using publicly available facility-level data from Centers for Medicare and Medicaid Services for 2021.
• Included 1092 IRFs.
• General linear models were used to assess the association between ownership type and 15 IRF-QRP measures, adjusting for facility characteristics.

Main Results:

• Ownership type was significantly associated with 9 out of 15 IRF-QRP measures.
• Nonprofit IRFs demonstrated lower readmission rates (within stay and 30-day post-discharge).
• For-profit IRFs showed better functional outcomes and higher rates of return to home/community, with higher per-beneficiary spending.

Conclusions:

• IRF ownership type is demonstrably associated with performance on IRF-QRP measures.
• Differences in performance suggest potential variations in care delivery models between for-profit and nonprofit facilities.
• Further research is recommended to explore patient-level outcomes and longitudinal effects of ownership type.