Executives and senior medical managers from rehabilitation hospitals and units across the country visited Washington, DC, recently for the American Medical Rehabilitation Providers Association’s (AMRPA's) Spring Executive Forum. While there, AMRPA members visited Capitol Hill to urge Congress to allow patients to receive rehabilitation care in rehab hospitals rather than in nursing homes when their clinical needs require it.
“There are several proposals that Congress may consider that could force patients needing the intense, specialized rehabilitation treatment provided in our nation’s rehabilitation hospitals and units into less-intensive care settings like nursing homes,” said Bruce Gans, MD, AMRPA’s chairman. “Our members are going to work very hard...to make sure Congress understands the critical role rehabilitation hospitals play in helping clinically appropriate patients quickly regain their health and skills and rebuild their lives.”
Specifically, AMRPA members asked Congress to:
- Prioritize outcomes over costs. The most comprehensive study to date shows that patients have better outcomes when treated in rehabilitation hospitals and units rather than nursing homes, according to AMRPA. The organization is concerned that “site neutral” payments, however, could override existing Medicare regulations and policies that require expert clinical decision-making to justify coverage for rehabilitation hospital use.
- Recognize that rehabilitation hospitals and nursing homes differ. Rehabilitation hospitals and nursing homes have some common features, but AMRPA says that the care they provide is not the same and should not be treated as such. Rehabilitation hospitals must meet stringent criteria to be licensed as hospitals, but virtually no regulations set quality standards or require proper medical supervision for rehabilitation provided in nursing homes, the organization says.
- Wait for more evidence on “site–neutral” payments. Post-acute payment reforms should not precede implementation of the Improving Medicare Post-Acute Care Transformation Act of 2014, which will provide a chance to analyze comparable data on patient outcomes, AMRPA says.