title: Site-neutral payment for postacute care: framing the issue.
abstract: This commentary evaluates the merits of proposals in the United States to create a site-neutral payment system for postacute care for patients with select rehabilitation-related conditions. Under a site-neutral payment system, Medicare would pay providers based on patients' clinical needs, not on the peculiarities of individual postacute settings such as skilled nursing facilities and inpatient rehabilitation facilities. This commentary frames the policy choices by taking into account the research evidence on setting costs and outcomes, the policy tools and preconditions needed for an effective site-neutral payment system, and the overall direction of American health and postacute policy.
authors.affiliation: MedStar National Rehabilitation Hospital, Washington, DC; Georgetown University School of Medicine, Washington, DC; and MedStar Health Research Institute, Washington, DC. Electronic address: Gerben.DeJong@MedStar.net.
authors.forename: Gerben
authors.initials: G
authors.lastname: DeJong
mesh_terms: D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006291:Health Policy / Q000191:economics; D006301:Health Services Needs and Demand; D006801:Humans; D008134:Long-Term Care / Q000191:economics; D008297:Male; D006278:Medicare / Q000191:economics*; D011050:Policy Making; D011445:Prospective Payment System / Q000191:economics* / Q000331:legislation & jurisprudence; D012047:Rehabilitation Centers / Q000191:economics; D012866:Skilled Nursing Facilities / Q000191:economics; D019467:Subacute Care / Q000191:economics*; D014481:United States
keywords: Recovery of function; Rehabilitation; Skilled nursing facilities; Treatment outcome