As health care has evolved in the United States, so has the acute care, rehabilitation, and postdischarge treatment of acutely spinal cord-injured persons. Advances in trauma care and the arrival of managed care health insurance plans have impacted inpatient and outpatient spinal cord injury rehabilitation practices. This article examines the changes in inpatient rehabilitation, length of stay, use of outpatient rehabilitation services, and treatment outcomes between 1995 and 2000. Inpatient lengths of stay have been stable, but use of outpatient rehabilitation therapy has increased in recent years. However, this has not produced any demonstrable improvement in treatment outcomes. Speculation is offered as to why this may be the case.