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Inpatient Care for the Cancer Survivor: Opportunities to Develop and Deliver Standards for Care

Raj, Vishwa S., MD; Pugh, Terrence M., MD

American Journal of Physical Medicine & Rehabilitation: August 2018 - Volume 97 - Issue 8 - p 595–601
doi: 10.1097/PHM.0000000000000943
Analysis & Perspective
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Cancer continues to evolve from a terminal diagnosis to a chronic medical condition. With improved survivorship rates, opportunities exist to deliver rehabilitation care throughout the oncology continuum. By definition, inpatient rehabilitation is generally considered postacute care and is provided either in inpatient rehabilitation facilities, in skilled nursing facilities, or in long-term care hospitals. Each institution is subject to specific regulations and legislation that help define appropriateness for admission based on diagnosis, medical necessity, and functional need. However, these criteria may present barriers to access care for the oncology survivor. As the healthcare landscape changes, and reimbursement structures shift from fee-for-service to those that emphasize effectiveness and efficiency in care, inpatient rehabilitation has a unique opportunity to improve value in terms of outcomes and cost. With the implementation of the Improving Medicare Post-Acute Care Transformation Act, standardization of measures throughout postacute care may allow for a more consistent approach to delivery of inpatient rehabilitation care. Further work will be necessary to define the parameters by which oncology survivors should be gauged in this framework.

From the Department of Physical Medicine & Rehabilitation, Carolinas Rehabilitation, Charlotte, North Carolina; and Department of Supportive Care, Levine Cancer Institute, Charlotte, North Carolina.

All correspondence should be addressed to: Vishwa S. Raj, MD, Department of Physical Medicine & Rehabilitation, Carolinas Rehabilitation, 1100 Blythe Blvd, Charlotte, NC 28203.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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