fah hospital policy blog

Perspectives on health policy affecting America’s hospitals and the patients we serve.

Category Archives: rehabilitation-care

“Positive Step Forward” – FAH on CMS’s Voluntary Appeals Settlement Option for IRFs

June 17, 2019 | Chip Kahn

Category: Medicare, Rehabilitation Care

Federation of American Hospitals President and CEO Chip Kahn issued the following statement on CMS’s Voluntary Appeals Settlement Option for Inpatient Rehabilitation Facilities (IRFs), which was announced this evening:

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FAH Suggests Improvements to Extreme and Uncontrollable Circumstances Policy

January 30, 2018 | FAH Policy Blog Team

Category: Medicare, Rehabilitation Care

In a letter sent today to CMS Administrator Seem Verma, FAH expressed appreciation for the new Extreme and Uncontrollable Circumstances policy for the Comprehensive Care for Joint Replacement (CJR) Model, which provides relief to the hospitals affected by this year’s disasters.

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FAH Urges MedPAC Not to Recommend Site-Neutral Payment Policies

December 18, 2014 | FAH Hospital Policy Blog Team

Category: Medicare, Rehabilitation Care

The Federation of American Hospitals submitted a letter to the Medicare Payment Advisory Commission (MedPAC) today, urging the group to stop considering site-neutral payment policy recommendations for inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs). The implementation of these policies on payment systems could ultimately lead to the opposite of the intended outcome: poorer patient care.

Several problems are associated with the potential payment policy recommendation, which the FAH letter outlines:

There is a lack of reliable clinical evidence and quality data. The Urban Institute study heavily relied upon by MedPAC has serious data flaws and limitations. A recent Dobson study comparing the effectiveness of IRF and SNF care has alternatively found better outcomes for patients in IRFs.

It is premature to implement site neutral payment policies until uniform assessment instruments, called for in the recently enacted Medicare Post-Acute Care Transformation (IMPACT) Act, are developed and ready to use.

Blunt site-neutral payment policies, without risk and case-mix adjustment as well as conforming regulatory change, risk placement of beneficiaries in clinically inappropriate settings.

The FAH shares MedPAC’s goals of making care more efficient and effective, with higher quality and better patient outcomes for Medicare beneficiaries, as well as a more patient-centered approach. However, site-neutral payment policies should be used very carefully and not in the absence of clear and reliable clinical data, which does not now exist.

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Senator Mark Kirk Stands Up for Rehabilitation Hospitals & the 60% Rule

November 21, 2013 | FAH Hospital Policy Blog

Category: Rehabilitation Care

Senator Mark Kirk (R-IL) penned an op-ed in The Hill this week, offering vociferous support for rehabilitation hospitals and calling for the preservation of the 60% rule. Kirk, who suffered a stroke in January 2012 returning to the Senate this year, touches upon his own experience with rehabilitation to highlight the critical care patients can only receive at an inpatient rehabilitative facility, or IRF.

“I credit returning to the Senate to nearly a year of intense, grueling physical and occupational therapy. It is now a major priority for me to help others who suffer from major health events to get back to work through rehab, and I believe access to specialized care at a rehabilitation hospital holds the key to meeting this goal.”

In the editorial, Kirk outlines the ongoing battle in Congress regarding the 60% rule, which would severely impact access to rehabilitation care for those who fall outside of the parameters of specific Medicare prerequisites. Kirk explains,

“This would be a mistake. Under the proposed change, some hospitals will close, and children managing cancer treatments or adults needing rehab after organ transplants will be turned away. A person who has survived a catastrophic infection or a complicated hospital stay but does not have the basic strength or endurance for mobility would also be turned away.”

IRFs offer specialized care that patients cannot receive in a hospital, nursing home or other facility. And as Kirk points out, numerous studies prove rehabilitative care is a more efficient and cost-effective means to help patients rebound and return to their normal lives. Kirk agrees with the sentiments of organizations like FAH, MedPac and CMS, who have already recommended maintaining the 60% rule as it stands today, adding,

“It doesn’t make sense to change the rule when the current framework helps individuals of all ages return to their productive place in society with the right remedies. We shouldn’t be holding patients back with options for lesser care, or worse, no options at all. Over the long run, changing the rule will only push people into reduced care, driving up costs and preventing them from returning to work faster.”

The FAH is glad to have the support of Senator Mark Kirk in our efforts to preserve the 60% rule so that all patients who require inpatient rehabilitative care can get the proper treatment they deserve. Senator Kirk is an example of the extraordinary improvement patients can experience with excellent rehabilitative care. That is the standard every American should have access to, should they ever need it. The FAH encouraged Senator Kirk’s colleagues on the Hill to support his efforts and stand with him in preserving access to IRFs.

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