Designing a funding system for rehabilitation services Part 2 achieving efficiency and quality of care

This paper examines the objectives of a funding policy for rehabilitation services.A casemix funding system comprises two sets of instruments: a classification systemand a payment system. Attention is given to identifying which policy objectives arebest pursued through each of these instruments. The paper then analyses the effectof various instruments on creating incentives for efficiency and quality, and assessespolicy options with regard to their capacity for dealing with the heterogeneity ofrehabilitation patients and controlling various forms of gaming. In conclusion, thepaper canvasses four major areas warranting consideration in advancing policy: theuse of a blended payment system; dealing with functional gain; the developmentof an information base; and the focus on designated rehabilitation units.