title: The insurance industry and the coverage of rehabilitation services.
abstract: Rehabilitation facilities are inescapably involved in the ongoing national debate over the financing and delivery of health care services. The relatively small portion of the debate involving our facilities does not involve questioning the need for rehabilitative medicine in serious trauma or illness, rather, the discussion revolves around how the services can best be delivered and the cost containment of the inherent costs. The recent interest evidenced by the government in DRG and related prospective payment plans is credited by some with effectively slowing the increase in health care costs. We believe that a careful look beyond just the numbers could demonstrate that cost "savings" are simply cost shifting to private payers. We believe that if DRG plans are strictly applied to rehabilitation facilities the results could be detrimental to both the facilities and their patients. Potential new markets are being explored such as the role our facilities can play in the area of treatment of catastrophic injury resulting from third party negligence. Liability litigation involving bodily injury is an area of enormous concern for the nation and its liability insurers, as is evidenced by the increased media attention given to the "liability insurance crisis" recently. The obvious long term cost containment effects of treatment in rehabilitation facilities is attracting the attention of the liability insurers as a potential vehicle by which liability exposures can be mitigated. The emergence of profit driven health care corporations and the enormous competition accompanying it is one of the most significant developments to be considered.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D003363:Cost Control / Q000379:methods; D007348:Insurance, Health; D006278:Medicare; D012046:Rehabilitation / Q000191:economics*; D014481:United States; D014942:Workers' Compensation