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Swing-bed hospital cost and reimbursement.

Small rural hospitals can provide long-term care in acute care beds as part of the National Swing-Bed Program enacted in 1980. Medicare reimbursement for swing-bed care is based on the incremental cost concept. This article estimates the incremental cost to hospitals of swing-bed care and assesses the adequacy of swing-bed reimbursement in light of those estimates. Other swing-bed reimbursement policy issues are discussed, including payment for ancillary services, potential bundling of routine and ancillary reimbursement, and the possible incorporation of case mix into swing-bed payment determination.