Unfortunately it isn’t how much they pay but what the patients aren’t getting for the Medicare money and who is at fault. The RUG’s system is for payment of input minutes of treatment not outcome improvement in mobility, home skills, transfers, strength, discharge integration back to the community … so it is first of all the fault of a terrible reimbursement method developed by professors who work for the Government.

The providers are expected to implement these academic averaging methods of payment that have no relationship to outcome or cost. Matter of fact outcomes for those problems haven’t been developed under the guise that the system would not be administratively simple … in other words the Government decides an based on some algorithm average payment for treatment and ignores the value of the services that are provided. Its been going on since 1975 when HEW was directed by Congress to deny claims even though the provider in good faith provided the services as defined in the regulations … so the Government started gaming and dictating the Medicare system of payment and they get exactly what they pay for … blame them not the providers who are continually accused of cheating the cheaters and cover themselves for denials.