Lunch Briefing on Complex Rehabilitation
Thursday, July 10, 2014

12:15 p.m.
Room 538 – Dirksen Senate Office Building

Food and Beverages will be served. 

The American Medical Rehabilitation Providers Association, the Amputee Coalition, and the Brain Injury Association of America will be hosting a lunch briefing on Thursday, July 10 at 12:15 p.m. to highlight a recently released study focused on outcomes of patients who have received rehabilitative care in inpatient rehabilitation hospitals.  The briefing will be led by the study’s authors- Al Dobson, Ph.D., Joan DaVanzo, Ph.D., and Audrey El-Gamil.  Representatives from the sponsoring organizations will be in attendance to explain the implications of the study for patients and how the findings add to the policy debate about rehabilitation care settings.  Food and beverages will be served.

We encourage members’ attendance at this highly anticipated event, as well as the coalition’s own luncheon (see below) held to discuss and prepare for Thursday’s event.

For more information, please contact Ashley Raspor (4-5842) in Sen. Johnson’s office or Cade Clurman (4-2854) in Sen. Kirk’s office.

Next Meeting

CPR All-Members Luncheon
Tuesday, July 8, 2014
1501 M Street, NW – 7th Floor Conference Room
Lunch will be served.

The Coalition to Preserve Rehabilitation will be hosting a Luncheon to discuss the upcoming Hill briefing regarding quality of care at Inpatient Rehabilitation Facilities (IRFs).  The briefing is scheduled for Thursday, July 10 from 12pm-2pm (location to be announced).  Please join us as we discuss and prepare for this important event.

Please RSVP to Theresa Morgan by Thursday, July 3. 

Recent Events

CPR sponsored a well-attended Congressional Briefing on Tuesday, November 1st, to highlight concerns with Medicare proposals that would severely restrict access and funding to inpatient rehabilitation hospital services.

The CPR is lead by a steering committee comprised of disability and consumer organizations including the Center for Medicare Advocacy, United Spinal Association, the American Association of People with Disabilities, and the National Council on Independent Living.  The coalition has had a five-year history, focusing on access to Medicare inpatient rehabilitation care, outpatient services, and Medicaid rehabilitation coverage.  More recently, the coalition has focused exclusively on policies proposed by the Obama Administration that would have the effect of restricting access to rehabilitation services under the Medicare program.

At the Congressional Briefing on November 1, Lee Woodruff of the Bob Woodruff Foundation was the lead speaker.  Mrs. Woodruff, the wife of ABC News reporter Bob Woodruff who sustained traumatic brain injuries while covering the war in Iraq in 2007, spoke of her family’s experiences and noted that it is easy to forget there are real people with a critical need for rehabilitation.  Her story of loss and triumph was truly moving and a highlight of the event.  Bruce Gans, M.D., Chairman of the AMRPA Board, introduced Mrs. Woodruff.

Jordan Thomas, a double amputee and CNN “Hero” from the Jordan Thomas Foundation, also spoke about his experience with injury and recovery through inpatient hospital rehabilitation.  Mr. Thomas lost his legs in a boating accident and spent his course of inpatient rehabilitation at Siskin Hospital for Physical Rehabilitation.  His experience in establishing a foundation so that children without means could afford prosthetic care was another moving account of personal triumph.  Now a 22-year old college student, he shared his experiences with inpatient rehabilitation that were instrumental in allowing him to return as Captain of his high school golf team and proceed to college in South Carolina.

The clinical impact of the inpatient rehabilitation proposals under consideration in Congress was addressed by Michael Lupinacci, M.D., President of the American Academy of Physical Medicine and Rehabilitation and a physician at HealthSouth.  Dr. Lupinacci illustrated the value of intensive medical rehabilitation services with personal accounts of injury, healing, and rehabilitation.  He also stressed how policies being considered by Congress would take rehabilitation options out of the hands of physicians and the rehabilitation team and into the hands of administrators and bureaucrats.  Dr. Lupinacci denounced several policies under consideration as inappropriate policy from a physician and a patient perspective.

The coalition has also embarked upon a media campaign to help educate reporters and the public at large on the harmful effects of these potential cuts on access to critical services for individuals needing rehabilitation.

The proposals before Congress include:

1) Reducing future investments in inpatient rehabilitation hospitals: The magnitude of proposed reductions in annual inflation updates to post-acute care under Congressional consideration is completely disproportional to Medicare expenditures in these settings of care.  According to the data, Medicare expenditures for inpatient rehabilitation hospitals and units has been relatively flat for the past several years, in stark contrast to many other areas of both acute and post-acute care spending under the program.  To reduce spending in post-acute care so dramatically over the coming years would deal a serious blow to the capacity of inpatient rehabilitation hospitals and units to accommodate the needs of an aging population with more acute disabling conditions. Maintaining access to this setting of care is critical for people with disabilities and chronic conditions.  In addition, studies demonstrate the cost-effectiveness of inpatient hospital rehabilitation by maximizing the functional capacity of individuals who receive such services.  The ability to leave the hospital and live as independently as possible in the home and community-based setting, as opposed to spending long periods of time in institution-based care, will avert the need for enormous unnecessary spending for these beneficiaries in future years.

2) Increasing the 60% Rule to the 75% Rule compliance threshold: Under this proposal, an IRH/U paid under the IRF PPS instead of the acute care hospital inpatient PPS, would have to demonstrate that 75 percent of the facility’s patients require intensive multidisciplinary inpatient rehabilitation and have one or more of 13 specified medical conditions.  But the data clearly establish that the 60% Rule has suppressed access to IRH/U’s for the past several years.  Raising the rule from 60% to 75% would further restrict access to this setting of intensive rehabilitation care and remove clinical decision-making from physicians and the rehabilitation care team.

3) Implementing “site-neutral” payment proposals restricting rehabilitation care.  These proposals would erect financial disincentives for IRH/Us to accept certain patients into the IRH/U setting of care.  This would further restrict access to these services in order to produce short-term savings for the federal government at the expense of patients.  The fallacy behind this proposal is that the outcomes of patients with certain conditions are equal when treated in either setting while the data establishes this is simply not the case.  Implementation of site-neutral payment for patients with hip fractures, joint replacements and other conditions as determined by the Secretary would simply eliminate access to intensive rehabilitation programs provided in inpatient rehabilitation hospitals and units. Rather than this level of care, these patients would be, in some instances, inappropriately diverted to a lesser intensive rehabilitation setting, contrary to the clinical needs of the patient.  Moreover, the data shows that there has been a significant decline in the number of joint replacement and hip fracture patients treated in rehabilitation hospitals and units over the past 5 years, therefore, patients who are currently receiving care in rehabilitation hospitals and units truly need to be in this setting.