American Medical Rehabilitation Providers Association (AMRPA)
Although the history of rehabilitation medicine dates back to the ancient Chinese, the field wasn’t acknowledged as a vital component of medical practice until the early 20th century when World Wars I and II provided the impetus to more formally deliver rehabilitative care. Pioneers, like Drs. Fred Albee, Henry Kessler, Frank Krusen, Howard Rusk and others, worked to redefine rehabilitation and broaden its purpose to best address the complex needs of both military and civilian populations with physical and functional disabilities. Their efforts resulted in the field of physical medicine and rehabilitation (PMR) being recognized as a board certified medical specialty in 1947.
During that time, hospitals expanded their programs and specialized, free-standing rehabilitation hospitals were established. Large or small, urban or rural, providers shared a commitment to best serve the scope of their patients’ needs through care delivery, research, education and support.
The American Rehabilitation Association (ARA), which evolved from several organizations including the 1952 Conference of Rehabilitation Centers and Facilities, advocated for both medical and vocational rehabilitation. Over time, however, leaders in the PMR community realized that a separate and singularly focused organization was warranted to best represent the issues unique to medical rehabilitation providers. In 1997, the American Medical Rehabilitation Providers Association (AMRPA) was founded to provide legislative and regulatory advocacy, policy development, educational resources, and technical assistance; and to advance the interests of the medical rehabilitation providers community overall.
The creation of AMRPA presented a new opportunity and renewed commitment to represent the continuum of medical rehabilitation providers with one voice. Since its inception, AMRPA has been a membership-driven organization, one that listens to its members, supports their operational and informational needs, advocates on their behalf and works with them to ensure their viability and access to the care they provide in an ever-changing health care world.
History and Highlights of the Growth of Medical Rehabilitation
- 1945: The American Medical Association (AMA) establishes a section on Physical Medicine and Rehabilitation (PM&R).
- 1946: The term "physiatrist" - first coined by Frank Krusen in 1938 to denote physicians specializing in physical medicine and rehabilitation - is adopted by the AMA.
- 1951: The Joint Commission is established, eventually becoming the largest standard-setting and accrediting body in health care.
- 1952: The Conference of Rehabilitation Centers and Facilities was founded. The name was changed to Association of Rehabilitation Centers (ARC) in 1962. In 1969, ARC merged with the National Association of Sheltered Workshops and Homebound Programs (founded in 1949) to form the International Association of Rehabilitation Facilities (IARF). The name was changed to Association of Rehabilitation Facilities in 1975 and later to the American Rehabilitation Association (ARA). These organizations represented the vocational and medical rehabilitation communities and led to the formation of AMRPA in 1997.
- 1954: Congress passes the landmark Vocational Rehabilitation Act, providing support and funding for programs to help persons with disabilities return to work.
- 1965: The Social Security Act amendments establish Medicare to provide health coverage to people age 65 and older, regardless of income or medical history; and, Medicaid for low-income or disabled individuals.
- 1972: Congress extends Medicare coverage to persons with disabilities on Social Security Disability Insurance (SSDI).
- 1973: The Patient's Bill of Rights is first adopted by the American Hospital Association with the expectation that hospitals and health care institutions will support these rights in the interest of delivering safe, quality and effective patient care.
- 1973: The Health Maintenance Organization (HMO) Act of 1973 is enacted, requiring employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional health care options.
- 1983: The Inpatient Prospective Payment System (IPPS) is established by the Centers for Medicare and Medicaid Services (CMS) under the Social Security Amendments Act to foster the delivery of integrated, effective and cost-efficient quality care.
- 1997: The Balanced Budget Act (BBA) of 1997 is passed by Congress and includes legislation to create the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS)
- 1997: The American Medical Rehabilitation Professionals Association (AMRPA) is formed following the dissolution of ARA. AMRPA is focused solely on medical rehabilitation with the goal of providing resources to medical rehabilitation providers.
- 1998: AMRPA holds its first Conference in Dallas, TX setting policy priorities for the organization. Initial efforts looked at grassroots problems facing rehabilitation providers.
- 2002: AMRPA first offers educational resources and classes to members and begins a series of Summer Regional Meetings.
- 2002: IRF PPS is implemented, five years after its authorization.
- 2003: The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is implemented, modernizing the flow of health care information.
- 2005: AMRPA prevails in a long-running controversy regarding the 75% rule with the passage of the Deficit Reduction Omnibus Reconciliation Act of 2005.
- 2009: Collaborating with other organizations, AMRPA launches the Quality Initiative, a national, multi-year effort to improve quality of care in America's long term and post-acute care facilities.
- 2010: Legislative Milestone - The Affordable Care Act (ACA) is enacted, requiring the Department of Health and Human Services (HHS) to implement a Continuing Care Hospital (CCH) model. AMRPA fought to have rehabilitation included in individual health benefits.
- 2014: AMRPA commissions the Dobson Davanzo & Associates study "Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities and After Discharge," comparing the outcomes of persons treated in inpatient rehabilitation facilities (IRFs) to those of similar patients in skilled nursing facilities (SNFs).
- 2018: AMRPA weighs in one the importance of including access to rehabilitation in advanced payment models, including providing responses to the Centers for Medicare and Medicaid Services (CMS) proposals regarding the Bundled Payment for Care Improvement Advanced (BPCI-Advanced) model and the Shared Saving Program Accountable Care Organizations (ACOs).
- 2018: The medical rehabilitation field grows to 896 rehabilitation units and 282 rehabilitation hospitals.
- 2019: AMRPA continues its legislative and regulatory efforts to enhance and promote the rehabilitation field through advocacy on Capitol Hill, within federal regulatory agencies, in the states, and through engaged members.
- 2020: AMRPA engages extensively with the Centers for Medicare and Medicaid Services (CMS) to procure the necessary regulatory waivers to facilitate the field’s rapid and evolving response to the COVID-19 public health emergency. AMRPA also secured a provision in the CARES Act which waived the 3-hour rule for the duration of the public health emergency. AMRPA hosts industry-wide COVID-19 response calls throughout 2020 to facilitate real-time education and information-sharing between AMRPA members, regulators, Congressional offices, and other stakeholders.
- 2020: AMRPA launches a new website to connect patients and their families and caregivers to inpatient medical rehabilitation care and provide a user-friendly experience, where they can learn what about the benefits of inpatient medical rehabilitation.
- 2021: AMRPA introduces a new professional certification for rehabilitation managers, the Medical Rehabilitation Management Certification (MRMC). The Medical Rehab Matters podcast debuts, discussing conditions treated and therapies used in inpatient medical rehabilitation, while addressing some of the legislative and regulatory issues that impact patients, their families and caregivers.
- 2021: In partnership with ATI Advisory, AMRPA released research highlighting the critical role inpatient rehabilitation hospitals played during the COVID-19 pandemic in admitting and treating complex patients with medical, rehabilitative, and behavioral health needs.
- 2022: AMRPA releases results of its nationwide survey of rehabilitation hospitals and units examining barriers to care for Medicare Advantage beneficiaries in need of post-acute care. The survey is a catalyzer for prior authorization reform legislation as well as potential regulatory changes.