REHABILITATION IN TRANSITIONByConstance J. Herold, OTR/LINTRODUCTIONThe Balanced Budget Act mandates a new payment system for rehabilitation beginning Oct. 1, 2001. The administratorsof XYZ Rehabilitation Hospital realize that the manner in which rehabilitation services are currently being providedwill not be financially viable under the new system. ThisWeb Quest has been designed to solicit employee input indevising new strategies for providing therapeutic services. Participation is voluntary, but strongly encouraged. The administrators highly value the experience, insight, and expertiseof the therapeutic staff and will strongly consider their re-commendations. This is your opportunity to design a systemthat will be effective and professionally rewarding for you.TASKYour mission is to develop a written plan to be submitted to administration for recommended changes to service provision.PROCESS• Organize yourselves into the following groups:– the federal perspective– the state perspective– the professional perspective– the management perspective– perspectives from related groups/resourcesPROCESS• Each group has 2 months to research their topic• At the end of 2 months, reconvene as a large group to discuss findings• Develop a plan for completion of the project• Written proposal to be submitted to administration Nov. 1, 2000FEDERAL PERSPECTIVEQUESTIONS• Answer the following questions:– How will Medicare payment for rehabilitation hospitals be determined?– What will the implications be for this hospital?– Are there other federal reimbursement mechanisms that can be accessed?– How will reimbursement impact practice and/or organizational structure in this hospital?FEDERAL PERSPECTIVERESOURCES• The following resources may be helpful to begin your research. You are free to add to this list.– Www.hanys.org/newsview/issues/balbud.htm (explanation of Balanced Budget Act)– Administration– BillingSTATE PERSPECTIVEQUESTIONS• Answer the following questions:– What are factors, specific to this state, that impact the provision of health care?– What are the implications for this hospital?– What state reimbursement mechanisms are available?– How will factors specific to this state impact practice and/or organizational structure in this hospital?STATE PERSPECTIVERESOURCES• The following resources may be helpful to begin your research. You are free to add to this list.– Www.klprc.net (What Next for Kentucky Health Care?)– Medicaid program– AdministrationPROFESSIONAL PERSPECTIVEQUESTIONS• What are the national associations recommending for these changing times?• Are there any examples of non-traditional service models or creative approaches to service provision?PROFESSIONAL PERSPECTIVERESOURCES• The following resources may be helpful to begin your research. You are free to add to this list.– Www.aota.org– www.apta.org– www.asha.org– professional publications– state associations, peersMANAGEMENT PERSPECTIVEQUESTIONS• What management models exist to facilitate organizational change?• Will organizational structure need to change in order to deliver service more efficiently and effectively?MANAGEMENT PERSPECTIVERESOURCES• The following resources may be helpful to begin your research. You are free to add to this list.– Www.prosci.com (reengineering ahd change management online learning center)– www.tompeters.com– administration– peers, other facilitiesRELATED SOURCESQUESTIONS• Are there other environmental factors impacting the delivery of service is this hospital?• Are there other perspectives/resources that would be helpful to this hospital as we redesign service delivery?RELATED SOURCESRESOURCES• The following resources may be helpful to begin your research. You are free to add to this list.– Http://amrpa.firminc.com (American Rehabilitation Providers Association)– www.ahcpr.gov (Agency for Healthcare Research and Quality)– State associations- I.e. Kentucky Hospital Association, Kentucky Association of Health Care Facilities, Kentucky Home Health AiiEVALUATIONThis activity is voluntary and as such is above and beyond your assigned job duties. There will be no formal evaluation or implications to salary or benefits. Upon review of the final project, the administrators may request further assistance/research for questions that have not been fully answered or implications thathave not been fully studied. Participants will be asked to perform self evaluation of the project for their own learning purposes.CONCLUSIONThis unit has been an attempt to solicit and utilize the talentavailable in this hospital. It has also been an opportunityfor the therapeutic staff to participate in the redevelopmentof service delivery methods. It is the intent of the administratorsthat this experience serve as a beginning to opening thelines of communication between staff and administrationso that we can work together to continue to provide thequality service that the community has come to expect from
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