Patients who come to inpatient rehabilitation hospitals or units have, for the most part, just survived a life-threatening event or major surgical procedure (trust me, this is a very scary thing too). How they bounce back to getting on with the business of life is truly amazing, and demonstrates a wonderful human quality, resilience. Happily, we can really help sustain that resilience and provide support to patients and their families while we train, fix, educate, and help them to rebuild their lives.
What we don’t recognize as frequently is how resilient our hospitals and units are as well. We have seen remarkable endurance, sustainability and indeed, resilience as our facilities cope with ever increasing regulatory burdens, pressures on payment, competitive forces in our markets, and aggressive efforts to “un-pay” us after care has been provided in good faith. Indeed, in the days of the Recovery Audit Contractor demonstration, the financial pressures broke that resilience down, and sadly a number of organizations succumbed to those unbearable pressures.
Today, we are facing astonishing threats wildly disproportionate to the good that we do, simply because it appears that our services are costly, and payers haven’t truly been able to recognize the VALUE we offer in both human and economic terms. Be they a Congressional push for introducing a flawed value based purchasing program (reimbursement reductions hidden in the sheep’s clothing of “value”), aggressive post-payment reviews and denials of coverage, the barbarians have gathered at our gates.
But we are resilient, because those patients who need us are resilient. We band together through membership in the AMRPA to support and sustain each other, and to have a loud and clear voice on the Hill and in corporate offices of payers and Medicare contractors that counteracts the short sighted and ill-conceived efforts to change payments and payment systems in ways that will harm patient access to needed care and even cost the country more in the long run.
Thank goodness all of you who are reading this have had the good sense to join and be involved in the work of AMRPA. Together we will be resilient and stay the course of helping the people who need us.
Bruce M. Gans, MD
Executive Vice President and Chief Medical Officer
Kessler Institute for Rehabilitation